Picture yourself standing on a narrow platform 20 feet above the ground, a narrow metal bar in your right hand. You plan to jump off the platform, swing along the pendulum of the bar’s cables to perform a trick in the air, then release the bar and fall 10 feet into the safety net. The only things besides the net that keeps you safe from injury is your confidence in the practice you have done with safety lines, the many times you have performed this trick before without incident. But this time, there are no safety lines to help you gently to the net if something goes wrong. This may sound anxiety-provoking, but in reality it is almost like meditation—take a deep breath, clear your mind and trust that your preparation has been enough, that your body knows the positions you have practiced without needing conscious thought.
You bend your knees, lift the bar in front of you and your toes leave the platform, the air rushes past you as you swing forward through the air. “Sweep back! Force out, toes up! Hollow! Sweep! Position!” You invert as you fly back toward the platform, following the auditory cues, swing forward upside down and wait until the very peak of the pendulum, when “Hep!” signals you to let go of the bar, extend your body and turn as you fall, bouncing twice on your back into the net. You have now completed a trapeze trick without safety lines, no anxiety or overthinking required.
Now take the same feeling, the mindset of trust in the preparation you have done, being present in the moment without constant self-doubt and apply it to life as a medical student in the middle of clinical clerkships. This is, undoubtedly, easier to suggest than to accomplish, at least if you are anything like me and experience daily imposter syndrome, never feeling that you know enough or have the experience to contribute meaningfully to patient care.
On my recent Family Medicine rotation in a rural Idaho town, I began to lose sight of my goals—the reasons why I chose to become a doctor— largely due to a feeling that I was not yet a real contributor to the medical team and the fear that I never would develop the competence to practice medicine. I began to feel burnt out, dragging myself through days in clinic, sitting down to study afterwards and instead falling asleep for an hour. Here too, the insidious voice of imposter syndrome whispered, “You’re just a medical student, you don’t have a reason to be burnt out compared to the providers you work with who have been at the front lines of dealing with the COVID pandemic for two years, you’re just being weak and there’s no reason to bother anyone with your little problems.”
I want to say, to all fellow medical students out there, that burnout is real, even now, as a trainee. Burnout is real, imposter syndrome is real and your mental health is real, and important. Have the courage to reach out to someone about it, whether it’s a preceptor, friend or other mentor. I did not do this, because of my insecurity that my own problems were insignificant and not worth sharing with others, and it got to the point where my preceptors noticed that my enthusiasm in clinic was waning and brought it up to me. During my end of clerkship feedback session, my primary preceptor casually handed me a tiny, plastic slinky shaped like a heart. Written on it was “Kickstart your heart.” Obviously, this was a relic of some campaign or other to encourage heart health, but I saw it metaphorically, with ironic timeliness. Rediscovering my heart, my enthusiasm for medicine, my “why,” was exactly what I needed right then, though perhaps she did not realize the ironic appropriateness of this little offering. More poignantly, though, she informed me that some of my preceptors had been noticing a lack of progress and gently asked me if anything was wrong. I briefly shared my feelings of burnout, loneliness and self-doubt, and found that she was understanding. Having it in the open helped immensely, but so did my metaphor from flying trapeze.
I discovered flying trapeze at the beginning of my third year of medical school, and it provides an essential release to balance the stress of clinical rotations. But more than that, it has taught me a great deal about life, and about how to approach and overcome imposter syndrome. A good friend came up with this motto for her trapeze school: “Breathe, smile, fly!” These are the steps she completes in her head each time she jumps off the platform, and I apply them to my life as a medical student as well, to foster positivity and overcome self-doubt and imposter syndrome.
“Breathe”- This is the first step, both literally and metaphorically: take a deep breath and let go of doubt and anxiety, trust the preparation you have done and banish the little voice in your head that says: “I can’t.”
“Smile”- Again, start with an actual smile, even if the feeling isn’t there yet. But, better, approach the task at hand with positivity. Enjoy the journey, rather than constantly wishing for the destination. In flying trapeze, the journey is the fun part! The destination, ultimately, is either the safety net or back to the platform, at which point you can rejoice at your success and breathe a sigh of relief that you accomplished it safely, but this would mean nothing without the journey to get there.
“Fly!”- Now, do the thing you came to do! Do it with full confidence and presence. Yes, you will make mistakes, you will not always succeed or do as well as you wished you had. But, if you put everything out there and did your best, then there is nothing to regret and you can learn from your mistakes and do better in the future.
Imposter syndrome will always be there, self-doubt will be there, but these lessons I have learned from flying trapeze provide me a way to overcome it, to trust the preparation I have done and to be present in the moment. Even as a medical student, I can be an active member of the medical team and make a difference to patient care, just by being present, being positive and being willing to do what I can and learn from my mistakes. There is not one answer to “why medicine?” It does not have to be something expressed in words, but instead is embodied by the feeling of positivity, the enthusiasm to go to the clinic or hospital each morning and see what the day brings. Sometimes, the why is bringing a smile to a patient’s face by joking with them during a visit, sometimes it is listening and allowing space for them to share difficult experiences and sometimes it is the excitement of getting to do a new procedure or neatly suturing a wound.
If I lose sight of my “why,” the first step is simple, yet momentous, just like jumping from the flying trapeze platform: “Breathe, smile, fly!”