James is Trying

I hate making friends.  Having friends is one of the biggest perks of being a human, but making them is the worst.  A real friend knows you.  All the good things and all the bad things.  Obviously.  And that’s fine.  Great, even.  I wish everyone knew me, knew everything.  But that would mean I have to tell them everything.  That’s where I tend to struggle.

I have to look at new friends and show them my darkness without knowing if they’ll understand.  I have to present the proof that I’m flawed, then stand there and wait for a response.  I’m too fragile for that.  It’s one of my greatest insecurities, as ridiculous as it might sound.  I don’t share my thoughts or feelings with people very often.  I’d like to, but I can’t.  It gives me anxiety.  Fills me with stress.  It’s outrageously distracting and can be super painful.

With this in mind, when I started my medical education at NCNM, I made a simple and strict rule for myself:  I will not attempt to build friendships if there is any potential for it to get in the way of my education.  I assumed that med school would be difficult enough without forcing myself to deal with the emotional burden of trying to show people who I am.  Education comes first and making friends will only be an added bonus.

The catch, of course, is that I’m extremely emotional and sensitive and contemplative and I have an incessant need to express what I’m feeling.  It has to come out somehow.  If I hold it in, it will spew out in the most unexpected and unpredictable ways.  I can’t have that.  I have to control its release, like letting the air out of an ever-inflating balloon that’s about to explode. 

In an attempt to not put the burden entirely on my angelic girlfriend, I’ve found that writing can mostly do the trick.  It sort of fools me into expressing myself without feeling too vulnerable.  But even writing is a constant struggle.  When there’s something I can’t stop thinking about, or some issue keeps me up at night, it takes me a while to admit it and get comfortable enough to actually sit down and write about it.

Then, I can sit here in my underwear with my hair sticking up in the back like Alfalfa and say what I need to, however I need to, without being afraid of it.  I can re-read, edit, rework and rewrite it until they’re no longer my thoughts and feelings on the page.  They’re nothing more than a string of words.  I can let people read it and not be concerned with the reaction.  “It’s just a story,” I can say.  And somewhere during that process, the burden leaves me.  The balloon makes it through another day without exploding.

For the most part, during my first year, it was easy to put my education before friendships.  It was as simple as showing up for class in the morning, spending the day being inundated with confusing information and then going home with stars in my eyes.  Easy.  But I was so busy figuring out how to do this whole med school thing that I wasn’t writing either.

I almost made it through my first quarter without incident.  During finals week, though, I realized how emotionally isolated and lonely I was.  I wrote a random story out of absolute necessity and shortly after, I caught a nasty cold that had me in bed for days.  The balloon was exploding.  I was able to recover during winter break, but still wasn’t writing or expressing myself at all, despite having so much to express.

During winter quarter, we had a new class called ‘The Cultivation of the Practitioner’.  It was a short 1-credit class (out of 27 credits), but it was a very welcomed break from our relentless basic science courses.  The focus of the class seemed to be on making sure we don’t lose our marbles during school or in our careers.  It involved actively figuring out how to take care of ourselves and how to handle the emotional role and responsibility of being a doctor.

On the first day of class, the instructor had us break into groups of three that we would work with for the whole quarter.  The few people I knew had quickly formed groups and I was left timidly standing alone.  Luckily, there were 2 very kind ladies who eased my panic and formed a group with me.  I’d seen both of them around, but never really spoke to either of them before that day.

Throughout the quarter, the groups had to discuss their thoughts and feelings about certain topics that the professor would prompt us with.  And for the first time at NCNM, I was talking to people that I didn’t know, in a class, about things other than science.  Because of my lack of writing and ever-inflating balloon, anytime I opened my mouth to say something, I had no idea what was going to come out.  I was terrified to speak, but I had to.  It was part of the class.  And it was as unpredictable as I expected.

We had a short assignment to free-write responses to a few vague, open-ended questions.  We were not required to turn it in, or let anyone read it, so I felt free to write about an awful, embarrassing experience I had in high school.  A story I had no intention of telling anyone.

During the following class, we discussed, in our groups, the themes and questions that came up during our free-writing.  My group had a nice conversation, but we didn’t come to any specific conclusions.

Then the professor said, “Ok, let’s go around the room so you can share your specific conclusions.”

Damn.

When my group’s turn came around, after a few seconds of the three of us sitting there shifty-eyed, filling our cheeks with air while the class looked at us, I started spewing out the details of my embarrassing high school experience.  I just kept talking and talking.  It wouldn’t stop.  I don’t have much memory of what I was specifically saying, but I vividly remember my repeating thoughts, “SHUT UP!  What on earth are you doing!?  Stop talking!  Abort!  ABORT!”

As soon as my mouth quit yapping out the uncontrollable words, I looked down and let out a defeated sigh.  I heard a classmate from across the room commend me for my self-awareness and offer some words of support.  I somehow wasn’t embarrassed.  It felt a little easier to breath, like I’d loosened a tie I’d been wearing all day.

In fact, throughout the whole quarter, every time I accidentally vomited out the thoughts that I was desperately trying to hide, I felt more and more confident.  I slowly started getting comfortable.  I certainly wasn’t openly expressing myself, but it was an improvement.

For the final class of the quarter, each group of three had to give a short, 2-3 minute, presentation to the class (about 85 students) on what ‘the cultivation of the practitioner’ means to them.  There were no limitations.  It could be a story, poem, song, skit, whatever, absolutely anything.  I’m sure the professor would hate to hear it, but between biochemistry, microbiology, anatomy, physiology, immunology and all of our other classes, this presentation was the absolute last thing anyone was thinking about.

On the Friday before our Monday presentation, my group decided that we should start to figure out what we were going to do.  I had an idea to write a poem that consisted of a bunch of “I will” statements outlining the journey from student to doctor.  My group agreed.

I went home to eat a quick snack before my Friday night workout.  As I was choking down my oatmeal, I felt the poem writing itself inside of me.  I stopped eating, sat down at my computer for about 10 minutes and wrote a series of 48 “I will” statements.  I emailed it to my group, finished my brick of oatmeal and left for my workout.

Later that evening, I read the poem to my girlfriend and after a few seconds of silence, she said, “Wow.  That’s really…honest.”  I panicked.  She was right.  It was way too personal for me to share with anyone.  I didn’t have the time to go through my long, outrageous writing ritual of thinking about it, re-reading it, editing it, rewriting it.  I simply wrote it.  The result was this poorly written poem that was far more than just a string of words.  It was my raw, unprocessed emotions exposed on a piece of paper.

I definitely didn’t want to read that poem to anyone, but I had too many exams to study for and couldn’t spend any more time on editing or rewriting it.  I submitted to the idea that I was going to read it to the class and ignored it until Monday.

My group’s time slot was towards the end of the class and after seeing all the other presentations, I actually started getting nervous.  I’m comfortable being in the spotlight, but I felt like my sloppy, hastily written poem was way too serious compared to the light-hearted and fun presentations that I’d been seeing.  I really didn’t want to read it.  Too late.  It was my turn to present.

I found my way up to the podium with my two group mates standing on my right.  I took a deep breath and started reading.  It was easy to find my voice.  My nerves faded.  I tried to ignore the content of what I was saying and focused on reading without stuttering.  I made it through the first four lines effortlessly.

As I finished reading through the fifth line, everyone laughed.  It hit me like a brick.  My feet got numb and my ears started ringing.  I could not understand what was funny.  My heart shattered like a melting ice sculpture being hit by a hammer.  If the door had been closer, I may have made a run for it.  Everyone was laughing at my words, my fears, my insecurities.  At me.  I was so hurt, embarrassed and vulnerable.

I decided that doing anything other than reading it until the end would only make the situation worse.  I continued reading and the room oscillated between painful silence and painful laughter.  After I finished, there was an applause and I quickly sat back down in my seat. I was devastated.  Classes eventually finished for the day and I slowly walked home, looking at my feet the whole way.

It took a day or two for me to realize that my perception of what happened and the reality of what happened were completely different.  It is pretty ridiculous to think that all of my classmates would actually laugh at me while I was reading something I wrote, but insecurity can do that.

I suppose my poem captured some things that nearly everyone in the class probably felt at some point during our first year, but no one said.  (You can read the poem here)  Some of it was so familiar and amusing that people laughed.  Unfiltered honesty makes for the best comedy.  But I wasn’t trying to be funny.  I wasn’t even trying to be honest.  It was a careless mistake on my part.  And it is one of the best mistakes I’ve ever made.

The result was connecting with everyone in that room on a far deeper level than I could have imagined.  For weeks following that little presentation, I was stopped in the halls.  I received emails and text messages.  I was thanked for my honesty.  I was called courageous, confident, aware.

But I didn’t think I was any of those things.  I thought I was insecure, scared and confused.  I realized something, though.  When it comes down to it, everyone is insecure about something.  Being courageous isn’t being without insecurity.  Courage is being insecure out loud.  Confidence is admitting fear.  These weaknesses instantly became strengths the second I communicated them.

The rule about putting my education before making friends was really just a decision to hide.  In fact, I don’t even think it’s possible for me to decide whether or not I will make friends.  That decision is left up to the people around me.  My only decision is to be honest and open, or not.  This is who I am.  My decision to express it or not has nothing to do with that.  But it turns out that it’s far less stressful to simply be honest and let everyone make their own decisions about me.

It was a lesson learned by hastily and accidentally writing an emotional poem, but my new rule is to be honest and open.  To be myself.  To never hide again.  It’s easier than I thought.  Building friendships, it seems, is a natural result.  And I have to say, med school is way more fun with friends.