How Good Are Your Coping Skills?

They say that the key to marriage is falling in love many times … always with the same person.

I wonder if this applies to the relationship you have with yourself. Life, if you are lucky and a little fearless and a little open-minded and maybe optimistic — but also a bit ignorant — is full of periods of exponential growth. I've had a few of them.

I like the kind of experiences that, looking back, I would probably never do again. I'm the kind of person who won't say "no" to the next never again.

I wasn't the same student in high school any more than I was in college or medical school. I remember my grandfather once telling me that college was where I would learn to study. As in, it was not the end, but merely the beginning.

You could read this two ways: that it was anticipated that I would go onto higher education; or it was expected that I would never stop learning and that college was a place for refining these skills — of assimilating facts in the grander schema of an ever-enlarging mind-map — then pulling them like a coin behind the ear, shiny with newness and glee (that the facts had not been lost after all). I embraced both interpretations, and I think that's what he intended.

The arc of my studying tendencies can be summarized like this: In high school I had no desk, even though my dad insisted that was no way to study. In college I had a desk, but I remember studying precious few subjects, namely organic chemistry and calculus.

This same desk followed me to medical school, where it got a lot more use. There are hundreds of marks on the whitewashed wall in front of my desk where I rest my feet while studying. They look like puppet shadow animals and I kind of like them; they are the only tangible sign of so many hours.

Medical school can be broken up into two distinct periods: pre-clinicals and clinicals. During pre-clinicals, students see very few patients and spend most of their time in class or alone, consuming knowledge in the form of biological processes and systems.

Once these pearls are neatly stowed away, students will reemerge only to enter another world: the hospital, a planet unto itself. And when you, the careful student, see your first patient, look into their eyes, and listen to the story of their illness, everything you have tucked away into your mind will be momentarily forgotten. What you've learned will eventually return in bits and pieces, and you will examine these facts gratefully, folding them with care.

A New York Times op-ed I read this week was titled "There Are Almost Too Many Things to Worry About." It's the most honest thing I've heard in a while. The past few years have felt like one long saga of "the sky is falling" à la Chicken Little. The only problem is I just don't know when the sky will stop falling, and I'm expected for hospital rounds tomorrow, sky falling or not.

So, I've been thinking a lot about coping skills recently, namely how old mine are (think: beloved stuffed animals with matted hair and an eye missing). In other words, old, and loved even more for their endearing imperfections. While my studying habits have developed and transformed over time, my coping skills have been largely unchanged since high school.

Medical school is a time when students tend to lean hard on the coping skills that help them keep their head above water. What if the challenges I face aren't keeping up with my ability to handle them?

My coping strategies throughout medical school have served me well, with a few notable exceptions. As any perennial runner knows, the body can be a capricious beast. Injuries new and old can flare even as the mind chants no, no, not now.

One of my body's worst timings was the months leading up to my first board exam when I developed retrocalcaneal bursitis ( inflammation of the fluid-filled sac behind the heel) that only grew worse with running and walking. I spent several months away from running while studying and seething; didn't it know I needed to be outside? I turned to swimming and called my mom more.

I participate in other activities too, but largely they revolve around being outside: I shamelessly walk through the dog park, dog-less; explore neighborhoods and lay claim to my dream home; listen to podcasts so one day I can tell my kids how inflation works.

My fondness for the outdoors could have something to do with living in a studio apartment, but I suspect it has more to do with feeling the wind or sun, even snow and rain.

Studying can quickly become an experience of sensory deprivation, sitting in front of a screen, hunched like the upper half of a question mark, tasting only the dregs of coffee on your tongue.

I can recall only a handful of times when my ability to cope has faltered: my first medical school exam, the first week leading up to my first board exam, a particularly challenging clinical rotation. How did I survive? I woke up. I ate breakfast. I said I was "doing well" enough times when asked how life was going that I started to believe it. I said tomorrow will be better, and it was — eventually. But could I have coped better? Could I have thrived under these new and challenging circumstances?

I know it's a tall order. But as I enter residency, I realize that having multiple healthy and constructive strategies to handle challenging days will be critical to my wellness. What are your remedies?

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About Liana Meffert

Liana Meffert is a fourth-year medical student at the University of Iowa's Carver College of Medicine. She has previously been awarded an Academy of American Poets Poetry Prize, Stanford's Irvin David Yalom Literary Award, University of Iowa's Carol A. Bowman Creative Writing Award, honorable mentions for the William Carlos Williams Poetry Award, and the F. Sean Hodge Prize for Poetry in Medicine. Her work has been featured in The Examined Life and The Healing Muse, among others.

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