Cluster W

3-12-2014 - 'If thou art pained by any external thing, it is not this that disturbs thee, but thy own judgment about it. And it is in thy power to wipe out this judgment now.'
- Marcus Aurelius, Meditations

Cluster W 

Cluster W is a new personality disorder category I've created for medical students. It stands for (unsurprisingly) whining. 

We all complain a lot. About lectures, lecturers, small groups, quizzes, tests, library chairs, library tables, libraries, professors, surgeons, internists, residents, attendings, fellows, other students, nurses, text size, powerpoint, ORs, EDs, surveys, emails, schedules, tuition, deans, EMRs, notes, ad infinitum 

But why? Why is whining and complaining so common among medical students? And why do we find it so acceptable to voice each and every one?

Pathophysiology:

We topped our college courses, crushed MCATs, and ruined exam curves for thousands. We volunteered away our social lives, and sat for countless hours watching proteins electrophores and encouraging mice to mate. We woke up at the crack of dawn to shadow physicians across the country. We worked hard to secure our place in medical school.

All of the above is crap. It is a common narrative to make medical students into martyrs, which we most definitely are not. 

The problem starts when folks start believing that their opinion is the Lord's gospel truth. We take the struggles we faced and persevered over as signs of our infallibility. 

Surely, if I've reached the lofty heights of medical school, I must be amazing! I sacrificed so much to get here! Therefore, everything I say must be important! 

One of the manifestations (among many many others) of this is the aforementioned whining. Everything that is a mild annoyance becomes a big deal. Almost ridiculous complaints surface. The following list contains things I've actually heard people say.

1. 'Why do they make us schedule 4th year so early? We should be able to do it the week before it starts!'

2. 'We should have our own private access library'

3. 'We shouldn't have to write notes!' (my feelings on this particular subject)

4. 'I shouldn't have to take call if I'm not even going into surgery'
5. 'We should have our own parking lot' (I am guilty of this one)

Diagnosis:

Medical students are not exempt from the insecurities faced by everyone else. However, given our success and the sense of entitlement explained above, we are far more likely to project them onto others.

Think of it like this. You're praised from day one about how smart, accomplished, and successful you are. Your family members look up to you, you are pursued by hopeful paramours, and you see the respect and prestige your title will bring you. Any insecurities you may have conflict with this new self-image. Therefore, they must be the fault of others! I should blame them! I would never make mistakes, or require criticism, so the other person must be wrong!

I see this most commonly when being criticized by residents. Residents, having been medical students just a few years earlier, are subject to the same personality characteristics as we are. So their critiques and advice can range from helpful and positive to belittling and malignant. That isn't the problem I'm getting at. The most distressing part of this is the inability of many of us to take criticism and complain appropriately.

I've seen fellow students explode on expletive laced rants in nursing stations after getting critiqued by residents and attendings. One person, who received the comment 'does not take criticism appropriately' on the end of rotation evaluation, exclaimed, 'doesn't take criticism appropriately?! Fuck you, I take criticism fine!' They didn't even blink at the irony. 

Central to success as a student (and in life) is the ability to temper your reactions to adverse situations. Not being able to control your reactions robs you of a learning experience and makes you appear childish to those around you. 

Differential:

All the negativity aside, medical students do have many legitimate things to whine about. Poor communication from various programs and courses that drops responsibilities on our laps last minute come to mind. Lack of guidance and expectations when starting clinical rotations is another one. Meetings that seem pointless. And on and on.

Problem is, this sort of stuff will never go away. At least things we whine about now generally come from our colleges that have interest in ensuring our success and happiness. Once we're dealing with insurance companies, medicare/medicaid, other providers, and countless other organizations, they won't be so understanding. 

Like everything else we learn to make habits in medical school, dealing with things we find pointless is an important one. Whining may relieve some stress, but in the, we need to find better ways to deal. Or you'll end up like the constantly negative residents and attendings we all know.