I was dripping with sweat even though I was standing still. I was dizzy. Inside my chest, I felt something new, different, and terrifying. A stampede of wild horses. The air was being knocked out of me. I had a hard time catching my breath. I was in the cardiac intensive care unit in a city called “the most dangerous city in America” in 2007. But I wasn’t a patient; I was the doctor. At that moment, I was calmly and methodically making my patient rounds, something I’d done every day for the previous two years.
I was the doctor in charge and fully in control, but in my body, things felt out of control. I was at a standstill in the doorway of a patient’s room, trying hard to stop whatever was happening inside me, quite seriously wondering whether I should be the patient in that hospital room instead. The nurse I was working with immediately sensed something wasn’t right. She told me to sit down and brought me some orange juice to drink. Seconds later, the feeling passed, and we both laughed it off. “It’s probably just low blood sugar from working overnight and not eating enough,” she said. I’d been on call the night before, and we’d had many hospital admissions. I’d had no time to eat a full meal, stay hydrated, or even use the bathroom – common occurrences for doctors in training. But still, something else seemed off, and the sensation had me shaking in my scrubs, literally. What had just happened to me?
I’d been working eighty hours a week in my medical training for the previous few years, spending every third night in the hospital on overnight calls. It was a coveted training program for the real-world exposure we received, an ideal learning environment for young doctors like me. But the unpredictable and harsh reality for doctors in training could be intense and sometimes shocking. One night, I saw a pregnant woman being wheeled on a gurney into the trauma ER with bullet wounds in her abdomen. We saw some gruesome stuff, but there wasn’t a spare moment to pause, catch our breath, or process what we witnessed. We simply kept going. There was always another seriously ill patient who needed our attention.
If I had a few minutes to spare in the hospital, I’d grab a cold turkey sandwich and a supersized caffeinated drink from the cafeteria and eat on my feet while making notes in patient charts. I rarely saw sunshine, except through the hospital windows. I didn’t exercise unless you count running from one patient room to the next. My sleep was erratic, at best. If things were quiet on overnight calls, I would catch a couple of hours of rest in the doctor-on-call room on a worn-out bunk bed. On busy nights, I didn’t.
It’s how the medical trainee world worked at that time. There was no spare moment to process anything, good or bad. We didn’t have the right terminology to describe the emotional aspects of our medical trainee experience. The words “self-care,” “stress,” and “burnout” didn’t exist in my vocabulary or anyone else’s two decades ago in the clinical world. I never questioned any of it because I wanted to be counted as someone who could handle it all like I had been taught to do.
Many years before I felt those wild horses in my chest, a teacher at medical school had told me, “Pressure makes diamonds, Aditi. By the end of medical training, you’re all going to be gleaming diamonds.” I believed him. I became strongly rooted in that belief. I loved the thrilling intensity of my work, so I unknowingly bought into the resilience myth (see below) and persevered through every stage of my trainee experience because, hey . . . diamond in the making here. But my body told a different story.
That day in the cardiac ICU was the first and last time I ever felt those wild horses during my waking hours. Instead, the palpitations followed me home and visited my body at night just as I was relaxed enough to fall asleep. I’d be jolted awake by the scary, out-of-the-blue sensations. After a half hour or more, I’d drift off to sleep, exhausted and in need of rest. Of course, I was terrified. But I kept it to myself. I thought it was a passing phase. I’d heard about medical student syndrome, a phenomenon where you feel your patients’ symptoms. Since I was a doctor in the cardiac ICU taking care of people’s hearts, maybe I had just become more aware of my own.
What I didn’t know then that I do know now is that my bedtime-only palpitations were a classic manifestation of the delayed stress response.
Excerpted with permission from The 5 Resets: Rewire Your Brain and Body for Less Stress and More Resilience, Aditi Nerurkar, HarperCollins India.
