System Overload- Dealing with Emotions in Medical School

EMILY HAUSE KAPLAN 02When I teach Bio 2, we always work through a passage about the neurons of the Aplysia, a genus of large sea slugs. The passage is focused on the effects of repeated stimulation of the nerves and the resulting effects such as habituation. Just for some background info, for those of you who haven’t been in my class, here’s what Wikipedia has to say about habituation, “Habituation is the decrease of a response to a repeated eliciting stimulus that is not due to sensory adaption or motor fatigue.” Basically, the more you poke the snail’s neuron, the less likely that poke is to elicit a neuronal response.

Now, why did I start off my post today talking about snail neurons? Well, it’s because I’m developing a hypothesis about why medical students become less empathetic during medical school, which I originally discussed here. I believe that myself and my fellow students are actually quite similar to those Aplysia neurons in that we’re being so emotionally stimulated that we’re beginning to experience habituation. During a single day, I go through literally hundreds of emotions in medical school. Here’s a small sample:

I’m happy when I do well on a test, understand a concept, or help a patient.

I’m excited when I get to perform a task in clinic for the first time, when a classmate asks me for my opinion or when I have an afternoon free post-exam.

I’m frustrated when I struggle with a test or important idea, when a patient is non-compliant with their physician’s medical advice, or when I work hard and that hard work isn’t evident in objective results.

I’m anxious that I am not smart enough to be here, that I’m forgetting an important assignment, or that I’m somehow not learning enough to be a good doctor some day.

I’m sad when patients share stories of their bad medical experiences in the past, when I talk to patients whose symptoms are negatively affecting their lives or when a patient dies.

I’m bored when I sit through a lecture on EMR or learn the same information about sickle cell anemia for the millionth time.

I’m amazed by the beautiful complexity of the human body, by the amount of caring and compassion that I see, by the power that exists in medicine.

This is just a small sample of the emotions that I feel in a day. I could include others such as being hangry, exhausted, and inspired, but I think you get the point that the list is long. Mostly I feel like feeling all of these emotions is leading to my emotional habituation.

I’m starting to understand why medical students start to lose their sense of empathy. I can barely handle experiencing and processing my own emotions, much less trying to feel the emotions of others. Medicine and particularly medical school is an emotionally exhaustive experience. My neurons are starting to mimic those of the Aplysia and I’m starting to feel less of a response to emotional stimuli.
Next week I’ll write about some ideas for potential solutions to this problem, but for right now, do you have thoughts? Anyone have suggestions about how to deal with emotional overload and the loss of empathy in medical school?
Happy studying!
  • Sarah L

    My experience is that it is not the emotions that are causing the detriment in our lives, but how we react to these emotions. Learning to control your reactions can help you get through the tough moments. When I’m feeling a strong negative emotion I try to take a step back, take some deep breaths and use some sort of positive thought to reassure my thoughts. I used to work with a sports psychologist (because many sports have a huge mental component to them) and there are biofeedback programs (similar to cognitive behavioral therapy) that are really helpful!

    • Emily Hause

      Hi Sarah,
      It’s true! You can always work on choosing how you react to your emotions. Regardless of how you react, you will still need to process them and medical school doesn’t exactly leave a lot of extra time for processing all of your emotions. I agree that we could all use a little more practice controlling our reactions. Thanks!

" "