Always a good sign

I chuckled when I got this e-mail. 

After speaking with several fourth year students and Dr. [X]... several of us felt it imperative to inform you all that there is NO box to check or area to denote any form of mental illness or having ever received counseling of any sort on the residency application. You tell a residency program if you have received counseling for or suffer from depression, anxiety, burnout, etc. AFTER you have matched. It will be the paperwork you fill out for the specific program like any other job you have had.
We bring this up because students fear seeking help from counseling services on and off campus. This is unnecessary as you will not be asked about such information when applying for residency during fourth year through ERAS. Please, PLEASE seek help if you need it. We have amazing resources available to us!

This is an old link from KevinMD, but it's relevant: Medical schools need to better recognize mental illness in students. 

Physicians have traditionally experienced higher rates of suicide than the general population – 40% higher for male doctors and a whopping 130% for female doctors. Students who enter medical school with a relatively “normal” mental health profile, in the end, suffer a higher rate of burnout, depression and other mental illnesses. In fact, over the course of med school, up to a quarter of students may suffer from depression and over half from burnout.

This is a friendly reminder that burnout, depression, anxiety, etc. are all a depressingly normal part of medical school. Please get treatment if you need it. To my knowledge nobody will know outside of your school's student health department, or whichever physician or counselor whom you see. Mental health issues are common and highly treatable.

I'm not surprised that one of the main hindrances to seeking help for mental health issues at my school appears to be "What if people find out?" I would like to think doctors and healthcare workers are more enlightened about mental health issues than other people, but I'm not sure the data really bears that out. My anecdotal experience sure doesn't.

So I wonder to what extent should medical students (or residents, or doctors) suffering from mental illness speak out. If you're in a stigmatized group, how much responsibility do you have to other people in the same boat?

Maybe that's the final step in getting better. Where you've reached the point where you aren't afraid to talk about it. Or maybe that has nothing to do with healing at all but rather with where you are in your career.

Step One fun, plus a tiny news roundup

It's nearly Step One time! Which is to say that in about two months' time, I will be tested on anything or everything that I've learned in the first 2 years of medical school. I will then almost certainly forget half of it within one week or so.

So, the part of my brain that isn't re-learning which special bacteria requires chocolate agar (Hemophilus influenza and Neissiria meningitidis, if you're keeping track) or what a PAS stain is checking for (glycogen, Whipple disease) has been reading through the news looking desperately for an interesting story. So far it looks pretty grim. Some guy in Nevada owes the federal government a lot of money. A dude I've never heard of who owns a basketball team made some dumb comments. A missing plane is still, uh, missing.

Instead of talking about those awesome topics, I instead am linking an article by Andrew Sullivan at the Dish, regarding John Kerry's remarks about Israel. If you missed it (and I forgive you if you have) John Kerry stated that Israel was in danger of becoming an "apartheid state" along the lines of South Africa. As far as I can tell, this is pretty basic stuff: unless Israel persuades a whole lot more Jewish people to immigrate, and fast, demographics are going to turn it into a Jewish-minority state.

Nothing about that is particularly controversial, in my opinion. Jeffrey Goldberg, who has written extensively about Israel's present and future, concurs.

By 2020, the Israeli demographer Sergio Della Pergola has predicted, Jews will make up less than forty-seven per cent of the population. If a self-sustaining Palestinian state -- one that is territorially contiguous within the West Bank -- does not emerge, the Jews of Israel will be faced with two choices: a binational state with an Arab majority, which would be the end of the idea of Zionism, or an apartheid state, in which the Arab majority would be ruled by a Jewish minority.

Which is all to say, I clearly don't understand the politics of the situation very well. Unless Israel's demographers have gone mad, the Arab population is going to become the majority group within Israel fairly soon. So if you are inclined to believe that the Jewish people deserve their own state, the only rational future seems to me for Israel to accept a second state. Waiting for demographics to force the issue seems like poor planning, and jumping on John Kerry for pointing this out seems quite frankly counterproductive.

Of course, I do assume people want a reality-based solution and not fantasy (Maybe Palestinians will be abducted by aliens! Maybe ten million Jewish people will immigrate overnight!) so I may be over-thinking things.

Finally, for a well-informed take that is more critical of Israel than I am, Juan Cole provides some good insights.