Hi. My name is Kareem Hamdy, and I am a new blogger here at the Merck Manuals Student Stories. I figured I would start with something personal. Medical students (and doctors) go through the same things as everyone else ranging from physical sickness and even mental health. Here’s my story and what I’ve taken from it.
I was the (almost) annoyingly optimistic guy in the group that never needed sleep, would be down for anything literally at any time. I was active, into fitness – an adrenaline junkie. Something changed during my second year; I needed sleep – tons of it. I could never get enough of it. I could literally sleep from Friday until Monday morning. I would get up, get water, and go back to bed. Friends of mine would bang on my door, and it wouldn’t faze me. My friends in class would joke that I had a tapeworm and possibly some African sleeping sickness (my family is originally from Egypt). I ate – a lot, but that was nothing new. Even with the slight gain, people always assumed that I actively was working out. I’ve always said that I “wear my fat well,” and it has always been easy for me to shed it and gain muscle.
At the end of my second year, I became withdrawn – I was just off. Being the problem solver for just about all my friends growing up, I became increasingly frustrated that I couldn’t figure out what was wrong with me. I became really depressed. I wasn’t able to study. Frustrated after being academically stagnant, I moved back home and thought maybe a change of scenery would help. It did for a bit – however being the uncle to three kids at home and the attention that children need was a nice distraction – which helped my depression initially. The more I thought about Steps and heard more and more of my friends passing, made me think about where I am in the process, bringing back my gut feeling that something is wrong – this time I acknowledged to myself what I was in denial about – I was suffering from depression.
I decided to go to Egypt for a few months, the idea was to “reset.” My plan at the time was to start my research project for graduation and study for Steps. While I was there, I started meeting doctors and looking at the healthcare system. I decided to experience it for myself. I went to a public hospital and decided I would do blood work. I did about 20 different types of tests for about $20. I felt like Oprah – just handing out blood tests orders for myself – “You get this test, you get this test!” and so on. I went across the street to a military hospital and did the same tests – I was thinking – it’s only $20, why not? I got the results and my cholesterol was over 300 and my TSH was in the teens.
A week later, I came back to the United States and took my results to another doctor. I brought up my symptoms again, and the response was the same, “Oh it’s probably just stress.” This time I said, “Are you sure about that? I have some lab results from Egypt that might point to an actual issue.” He looked at them and said he would redo the labs here and to follow up in a month. I went to the lab as soon as they processed the results and called the doctor, telling them they might want to see me sooner than later because of my results. They called back shortly after and wanted me in that same week to tell me what I already suspected. The best-case scenario – I have an autoimmune disease known as Hashimoto’s; the worst-case scenario, I have thyroid cancer.
Either way, at least I knew I wasn’t crazy. I had something to explain why I was always just off, really down, foggy, and always sleepy. I was consuming about a half a gallon of coffee a day to stay functional. It literally took a trip to Egypt, and my Oprah moment to get some sort of diagnosis. I’ll eventually explain everything up to my diagnosis in another post, highlighting what I learned there.
What I learned here, and what people may not always think about, medical students aren’t robots. Things come up, life happens, and we adapt. Listen to your gut, and listen to your patients. In healthcare, there is a push to stop unnecessary testing. Doctors should have tested my TSH levels; if they did they would have seen it close to 30 (which is high). Being a guy with an athletic build with no goiter, they just ruled out thyroid issues by looking at me.
Doctors definitely shouldn’t be doing the Google method – “Let’s collect as much data as we can and see what we find.” My physician friend yelled at me, solidifying the idea that blanket ordering doesn’t make you a great doctor, backing up or reasoning with why you need to order specific tests will. As a medical student, I understood the physiology; I just didn’t listen to my gut. Every time I went to the doctor’s office I wasn’t a medical student, I was a patient. I was reminded the blind trust we have in our physicians by patients. Even though my gut said one thing, I listened to my doctor – further solidifying the responsibilities and the oath we take to do no harm.