Nov 20, 2008

My Weekly Anxiety Attack

Jeff Wonoprabowo -- I remember when I was in first grade, my teacher would split the class into teams and we would play trivia tic-tac-toe. Whichever team was able to answer the question correctly had the chance to place an X or an O on the board. At one point I answered so many questions in a row that she instituted a new rule: Jeffrey can't answer every question.

Somewhere along the way, I have no idea when, I stopped wanting to answer questions -- even when I knew the right answer. Thinking back to my college days, I don't think I ever raised my hand to answer a question or offer an opinion. I only did so when called upon. Maybe I didn't want to sound dumb saying the wrong answer, I don't know. All I know is that I've gone from an excited first-grader basking in the spotlight of answering questions to someone who would rather just sit quietly and let the spotlight fall on others. Now that I'm older and wiser, I know the value of being "cool." And it can be quite stressful being put on the spot, with the wrong answer, or no answer at all, rolling off your tongue.

In medical school, about once a week, we have a pathology session that involves team-based learning. During these sessions, the class is divided into groups of five (these groups work together throughout the whole year and various different classes as well). Each lab session is intended to help reinforce the material we covered in lecture during the previous week. And this is where I am guaranteed my weekly episodes of anxiety and stress.

At the beginning of the lab session the groups are all given a laptop and we take a group quiz on the computer. Once that is submitted, we receive a worksheet with about 12 clinical vignettes. We must determine the disease for each one and answer questions about each particular case. (These questions will ask for things like the mechanism, clinical presentation, comparisons with similar diseases.)

After about 40 minutes, our course instructor picks up a microphone and announces that our time is up. His assistant walks over to a group and hands the microphone to a person of her choice. At this point, Nervous Student (NS) has the eyes of the entire lab (almost 100 pairs) on NS, and NS has no choice but to take the microphone and announce his/her name and group number. And the encounter might go something like this:

Professor (P): "What does this patient have?"

NS (answering with a shaky voice): "Carcinoma-in-situ"

P: "And what condition most likely preceded this lesion?"

NS (drawing a blank): "Um..."

P: "Consult with your group."

After conferring with the group, NS replies: "HPV infection leading to dysplasia."

P: "Good, and will the biopsy reveal malignant cells penetrating the underlying basement membrane?"
NS: "Uh.. I don't think so."

P: "Of course not."

NS (sounding very confidant): "Oh, right. Of course not!"

Cue class laughter.

The encounter might seem quite benign. No harm, right? But every time I go to lab I am anxious and apprehensive hoping that the microphone is not pointed in my direction when it is my group's turn. And I get the feeling that I'm not the only one who feels this way.
Maybe it's good for me and will prepare me for the pimping that will come during third and fourth years. Then again, with all the stress and anxiety, maybe it's bad for me.

Oh, who am I kidding? Medical school is a big ball of stress and anxiety, and that much more can't be that bad... Right?

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