Red Flags

 Perspective/Opinion

From the 5/14/2021 newsletter

Perspective/Opinion

Red Flags

Margaret (Meg) Lieb, MS

Ms. Lieb is the current medical student representative for MCW’s Suicide Prevention Council and a co-founder of the council’s inaugural program, Seeking Peer Outreach (SPO). In this issue, she reflects on how her past gives life to her vision for future of SPO …

I remember trembling in a bustling coffee shop as I numbed the buzz around me to delicately lay each word in place. I was clenching every muscle in my body to contain the explosions in my chest vibrating my fingertips. I was eighteen, and I was writing my first personal statement. As with every personal statement since I was firmly instructed to “address [my] red flags.” My caveat: it is impossible to explain my red flags without also disclosing my most painful, darkest, personal secrets.

How do you address a big, red, domestic violence charge without sharing that it was the first time I tried to fight back after a year of abuse? How do you justify enduring an entire year of abuse without conveying I intervened in his suicide the year prior and was terrified for his life? How do you fend off assumptions about my judgment without explaining it was my first love, and I simply did not know better? How do you describe the ways it was formative without reliving every traumatic memory and its sequelae?

After nearly ten years of writing and re-writing my sharpest pain and deepest shame for various admissions committees, I have yet to craft a different answer.

However, time gifted me the hindsight to reflect on ways I grew into my red flags, in ways, driving my purpose. For instance, I was nominated to sit as the student representative for MCW’s Suicide Prevention Council (SPC) last year. One of my mentors challenged me to imagine the intricacies of a culture in medical education where we would not be forced to question, “When is it safe to be me?” primarily when applied to well-being and mental suffering.

As I reflected on this concept and connected it to my own experience, I realized it never was safe for me. However, with each rendition disclosing my history, I grew from tolerating my forced vulnerability to comfort to strength in my vulnerability. This concept of ‘strength in vulnerability’ has been integral as I helped develop SPC’s first initiative, Seeking Peer Outreach (SPO). How do you breathe strength into brilliant, high-functioning individuals, who are also struggling to dress in the morning, to be vulnerable enough to seek help?

Make help active and accessible 

Our approach to this: make it easy and make it normal. In applying this to SPO, I’ve called it “active accessibility.” Active because we are placing the responsibility of getting support away from a person potentially suffering and, instead, giving it to everyone else in the community by setting the expectation of actively and regularly reaching out. Accessible because we considered existing barriers to requesting or receiving help and have streamlined circumventive processes.

We are augmenting active support via a subset of individuals identified by others in the community as being particularly approachable and empathetic. This group goes through additional training, is equipped with various resources to share, is tasked with checking in with all individuals regularly, and displays a specific version of the SPO logo as a silent signal. The signal conveys the pledge to share their vulnerability, support, resources, and confidentiality for anyone who may need it at any time. 

Additionally, we are enhancing accessibility through an innovative anonymous reporting platform for anyone burdened with barriers to revealing their identity. Each SPO logo will be an embedded with a QR code directly linked to an encrypted submission page. Any submission will go to the SPO peer support team, who will be able to respond accordingly. Further, every person will be provided a pin displaying the QR code and encouraged to keep it on their MCW badge. Therefore, every member at MCW will carry an anonymous means of support with them at all times.

We are not alone

When I joined the SPC, I knew there were very few people in my life who understood what I had been through; thus, I was sure no one at my institution could personally relate to my lived experience: a lonely burden to acknowledge. 

A year later, I am astounded and inspired by how wrong I was. As we selected leaders for the SPO pilot program at MCW’s satellite campus in Central Wisconsin, I was adamant that our leadership be committed to being the best example of the program’s mission. In response, a few weeks ago, I sat with next year’s selected SPO leaders, composed of 25% of the Central Wisconsin M1 class, faculty, and staff. Each person shared their personal dedication for SPO by disclosing their own big, red, scary secrets. Many secrets that were strikingly similar to my own. It was a powerful meeting that served as a beacon of hope, a seed for compassionate collaboration, and the ribbon-cutting for strength in vulnerability. 

Most notably, it would not have been possible without the influential faculty members who take extra steps to help their colleagues and students feel safe in their vulnerability. Further, I would not have been able to co-lead the formation of SPO without the same faculty who empowered my voice and simply left the door open. 

I couldn’t be more grateful for them or the skills they granted me to pass the torch for those to come.

Margaret (Meg) Lieb, MS is a second-year medical student at MCW-Central Wisconsin. She serves as the medical student representative to MCW’s Suicide Prevention Council. 

Stigma and Vulnerability: Our Experiences with Struggling in Silence

 From the 5/14/2021 newsletter

Perspective/Opinion

 

Stigma and Vulnerability: Our Experiences with Struggling in Silence

 

Sofie Kjellesvig and Sadie Jackson - MCW-Central Wisconsin medical students

Medical students are high achievers who are often adept at hiding their shortcomings and moments of vulnerability.  We, the authors, hear our peers admitting to some of their struggles: being behind on lectures or not feeling ready for an exam, for example, but these statements are almost always qualified by, “but it’s fine, I’ll be okay,” or something similarly diminishing.  In fact, there are times when we have felt unsure about whether things will truly be okay. We do not openly share these feelings, no matter how many times we’ve considered doing so.  Perhaps this is out of fear of what others may think, a belief that we are suffering alone, and the stigma that surrounds academic performance and mental health. 

We’d like to break the silence by illustrating some of the ways each of us struggled during our first year of medical school:

 

Academic challenges can break down students’ confidence and isolate them as soon as classes start. For anyone who hasn’t had a cadaver lab before, anatomy in medical school can be a rude awakening. Among the class there are seasoned veterans with extensive dissection experience, some students who have taken anatomy and held a scalpel a few times, and then students like me who had never heard of the pisiform bone, let alone picked up a probe. Anatomy scared me and I didn’t feel like I belonged in lab. With time and practice I improved, but I still found it very difficult. No matter how far I progressed, I couldn’t shake the feeling that I was not good enough and was falling behind my peers. Ultimately, I found myself asking if I was cut out to be a doctor and struggled with worsening anxiety about this. I was uncomfortable admitting how much those feelings pained me to classmates who appeared to breeze through the course.

 

Why is this so challenging? Our grading for these courses is pass/fail, so why do we compare ourselves to peers and consider ourselves a failure if we don’t measure up? What I found out when I did make myself a little vulnerable was that friends who were excellent anatomists still had their own issues at times: they had these feelings about a different course, or they were having trouble with school/life balance, or they were just finding life in general to be a lot harder during pandemic times.

 

Other challenges, especially those related to mental illness, are rarely shared by classmates. This is not because medical students suffer from mental illness less than other groups.  Mental health and suicidal ideation, understandably, are heavy topics for most people.  Even though some of us may feel comfortable sharing our experiences with those who ask, we encounter barriers that prevent us from reaching out on our own accord.  I find myself asking: when it is a good time to bring up such a topic? Is it fair to place such a burden on others who did not ask for it? Will they view me differently if I share my insecurities?  My anxiety convinces me that sharing will make others uncomfortable, beginning the vicious cycle of negative self-talk that I try so hard to avoid.  I then feel that it will be easier for all if I deal with my doubts alone.  This option becomes more appealing to me to protect myself from the guilt, discomfort, or judgment I fear may come with allowing myself to be vulnerable. When I have been brave and shared, however, I’ve found that I am not alone and that others do care and sincerely want to help. I doubt I am the first person to wind up trapped in the self-imposed isolation these fears can create.

 

Vulnerability is an important skill that, like other skills, takes time and practice to learn. Whether you’re struggling with biochemistry concepts, having difficulty managing depression, or possibly grappling with suicidal ideation, remember that you are not alone.  Students in medical education are held to a high standard and are told to behave like future healthcare professionals. Unfortunately, the very individuals we are meant to model face significant stigma and barriers to admitting when they need help, so it’s no surprise that we find it difficult to stray from these behaviors. 

By sharing our experiences here, we hope to help students realize that they are not alone and that being vulnerable is not a weakness, but a way to reduce the stigma and isolation which many of us experience.

 

Sofie Kjellesvig and Sadie Jackson are medical students at MCW-Central Wisconsin. Sofie is an M1 at MCW-CW who is interested in internal medicine. She is from Eau Claire, WI and graduated with a degree in biomedical engineering from the University of Minnesota prior to coming to MCW. Sadie is an M1 at MCW-CW who is interested in family medicine. She is from Stoughton, WI and graduated from Kalamazoo College with a biology major and studio art minor.  

Minding our Mental Health

 From the 5/14/2021 newsletter

 

Perspective/Opinion

 

Minding our Mental Health

 

Toni Gray - Office of Diversity and Inclusion

 

Ms. Gray writes about her family’s experiences and how unconscious bias disproportionally affects communities of color …

 

I was nineteen when I got the call. My mom was in the hospital. She had swallowed several pills. She had attempted suicide. The emotions that filled my body included anger, sadness, shame, and back to anger. My mom, a mother of seven, felt that the best thing she could do to solve her anguish, her sadness, was to take her own life and leave the lives that she had help create; searching for answers and never getting them.

Fortunately, my mom survived, but she would continue to deal with depression and anxiety. It is something that runs in our family, and I would soon lose two cousins at early ages to suicide.

As I reflect on why I wanted to write about this painful subject, it was clear that my personal experience was important to me. One of my favorite quotes is: “Make your mess your message.” Isn't it true how so many of us suffer in silence because we are ashamed of the personal struggles that we face, the trauma that we hold, and the doubts that we cater to? They hold us in a guilty place where we do not often know who we can turn to and trust with our deepest, painful secrets.

However, mental health is becoming less of a stigma and I am so grateful for that. We are opening up the door for conversation and connection which allows compassion to reign. But we dare remind ourselves that part of the mental health stigma depends on the color of your skin and your culture.

In the African American/Black community, there is a strong spiritual basis that we hold to our hearts that is handed down in tradition by our great grandmothers and grandfathers, and our ancestors. That is the idea that a higher power can heal all our illnesses. And that if we have depression or anxiety, we are not relying on the higher power enough which compounds the feelings of guilt that we may already be holding. Our faith is called into question. This stigma has plagued the African American/Black community for many decades. Besides that, we still have the effects of systemic racism where African American/Blacks were denied access to health care and now even in the 21st century health care still remains an access and economic issue plagued with unconscious biases.

When you are trying to open up your heart with innermost thoughts, you want someone that you can trust and someone who may relate to you. Compounded by the economic restraints and access to therapist is that often you cannot find a therapist that looks like you if you are a person of color. They say representation matters. I second that and elevate that it is imperative. People feel connected to people who look like them in a society that villainizes you for looking a certain way. We need to find people who can relate to the unique societal struggles that people of color face.

As an institution, I believe we are truly committed to creating equity in healthcare. We are committed to building awareness with intentionality around intersectionalities that people come in with and finding ways to address unconscious biases that impact health care outcomes for people of color. That includes the mental strain of poverty, police brutality and profiling, the killing of Black and Brown bodies by police officers, on top of the ongoing effects of this pandemic. We have much work to do in the mental health space, but I am grateful that we are now understanding that our mental health matters just like any other health concerns we may have.

As I reflect on my mom’s journey of resilience, I am comforted by her story. She realized the need to see a therapist to get the tools she needed to deal with her depression and anxiety. Hearing stories like this makes us feel not so alone in our pain. We are human; we bend but we do not have to break. However, we need the resources accompanied by compassion so that we can stand up straight again and embrace a full life we all deserve to live.

 

Toni Gray serves as the Learning and Growth Program Coordinator in the Office of Diversity and Inclusion at the Medical College of Wisconsin. She’s been with MCW for 10 years. She oversees, leads, and creates learning and growth experiences in the equity, diversity, and inclusion space.

 

 

Why Suicide Prevention, Kerri?

 From the 5/14/2021 newsletter

Perspective/Opinion

 

Why Suicide Prevention, Kerri?

 

Kerri Corcoran writes about why she has found a calling working is suicide prevention and provides resources for those who are in crisis …

 

Hello, I’m Kerri, the Student Behavioral Health and Resource Navigator in the MCW Office of Student Services. I am active in the MCW Suicide Prevention Council and in the implementation of a pilot suicide prevention program at the Central Wisconsin Campus.

I have been reflecting on the idea of my “why” and, honestly, feeling a bit…underwhelmed. As a mental health professional, one might assume there is some existential reason behind my career choice and dedicated focus on promoting wellness. There must have been some major life event which led to this greater purpose of supporting those who find themselves feeling hopeless and in crisis. The truth is that I have been very fortunate to not have had a significant personal experience with suicide. As a licensed clinician working in community mental health over the past eight years, I have had experiences with assisting those in crisis and having clients die by suicide. Even when taking these difficult experiences into consideration, I found myself questioning my own ability to claim some part of this initiative. I know there are individuals serving alongside me in this council who have been through some of the biggest challenges this world has to offer. Is it possible to have Imposter Syndrome as a member of a council? Apparently so.

And then, it dawned on me. Maybe, this is the point? This is the purpose of developing a program which trains as many individuals at MCW as possible in heightening comfort around discussing suicide, in training student peer supports, and making sure everyone is aware of the mental health resources available. Suicide prevention is not the job of just those who struggle with mental health, or who have lost a loved one to suicide, or who have struggled with suicidal ideation in the past. Suicide prevention is the responsibility of everyone.

Everyone at MCW needs to be a piece of preventing suicide and showing those within our community that we care; really care. Common humanity is my “why.” Knowing that life is truly worth living, unconditionally, is my “why.” My love for my community is my “why.” 

And I think that might just be enough.

 

If you or someone you know is struggling, please reach out! See the linked decision trees to learn more about the available resources at your campus.

Milwaukee Campus “Assisting Student in Distress or Crisis”

Green Bay “Assisting Student in Distress or Crisis”

Central Wisconsin “Assisting Student in Distress or Crisis”

 

 

Kerri Corcoran is a Licensed Professional Counselor and Clinical Substance Abuse Counselor. As a Behavioral Health and Resource Navigator, she provides students with a safe and secure space to talk about challenges and work closely to implement solutions. She works in the Office of Student Services at MCW.