No. 8: The time I had a panic attack

7 Minute Read
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2nd Year, Medical School: Spring

“So, what do you say, Beautiful? Will you do me the honor of going to dinner with me tonight?”

I read the text over and over, contemplating the potential consequences of agreeing to go to dinner with him (henceforth referred to as Jason for anonymity). If it had been another time in my life, I would have accepted without hesitation; Jason seemed like a nice guy and I didn’t have major plans that night. The problem with this particular evening was that it was two weeks out from the infamous Step One exam.

For context, Step One is the first and hardest of a series of three board exams medical students and doctors have to take to become licensed physicians. It is important because you cannot progress to the next year of medical school without passing it, and your score on this exam often determines which specialties you can successfully match into. Medical students are inundated early with horror stories of people who failed Step One and couldn’t continue to their next year, or worse, people who passed the exam with a very low passing score (which in many cases can be worse than failing, since failing allows you to retake the test and try to get a better score later).

Needless to say, at two weeks away from the exam, I was STRESSED. I had been studying 12-13 hours a day for the last four weeks. All I did was eat, sleep, and study. I was off social media so I could get my head in the game, and by this point I had mostly stopped studying with friends to prevent myself from getting distracted and goofing off. Most days, I felt lonely, tired and filled with doubt.

To be honest, I wasn’t worried about failing the exam. I had done well enough in school up to that point, so I knew I would likely pass. On the other hand, I was sick to my stomach with worry that I wouldn’t get a high enough score to match into dermatology (which is considered a competitive specialty, usually requiring higher scores to even be considered for interviews). At the time, I wasn’t sure if I wanted to go into dermatology or OBGYN, but I had been advised to aim for a score high enough to match into the more competitive specialty just incase (good advice). There were days when I did well on practice tests, and felt like everything would be OK. There were other days (MANY of them) when I got suboptimal scores on practice tests. Those were dark days. Imagine spending almost every waking moment for weeks studying for one thing and having practice scores that were DECREASING. Yep. Dark times.

My only relief was the one day I took off a week (a full 24 hours) for rest. I already had the habit of observing “Sabbath” by not working or studying from sunset on Friday evening to sunset on Saturday evening for spiritual reasons, so continuing in this tradition allowed me to have guilt-free rest every week. So I put in WORK from morning to evening Sunday to Friday. Every Friday as the sun began to set, I would CHEERFULLY put my books away. And every Saturday as the sun began to set, anxiety would creep up as though it never left. I’d begrudgingly pull my laptop and books out and study hours into the night.

So when Jason asked me to go to dinner with him on a Saturday night, I was considering breaking one of my rules, and taking MORE than my 24 hours/week off. He was asking me to give up 2-3 hours of precious study time for the most important exam of my life. Was a date with someone I didn’t know that well worth it?

After much deliberation, I decided to go. After all, I had been working tirelessly for four weeks. I deserved an extra break, right? And a girl has gotta eat, right? Plus, I told myself I would go and come home within 3 hours max, giving me time to study for about 1-2 hours before going to bed that evening. No harm, no foul. Jason told me how excited he was, and that he would pick me up at 7pm on the dot.

As I looked through my closet to pick an outfit, I couldn’t shake a deep, nagging feeling of guilt. I had just taken 24 hours off, and really couldn’t afford to lose any more time so close to the exam. I’d heard people describe studying for Step One as trying to drink water from a garden hose. This was a GROSS understatement. For me, it had been more like standing underneath a waterfall, attempting to catch every drop with a single bucket. Those seemingly infinite drops of water corresponded to deep intricacies of the human body, pathophysiology of diseases you never even knew existed, and details about the way hundreds of medications worked. And my poor brain was the bucket.

Still, I continued to get ready, settling on a forest green dress and black, strappy heels. I brushed my hair into a sleek side ponytail, put on foundation, winged eyeliner, and a touch of lipstick. Looking in the mirror I thought, You deserve a little fun, baddie. Calm down. The test isn’t going anywhere, this stuff will be here when you get back.

I was running a few minutes late getting ready, and hoping that he might be a few minutes late too. For that reason, I was relieved when he hadn’t called or texted me saying he was outside yet, although it was 7:10. I needed another 5 minutes for finishing touches. I turned 7/11 by Beyonce on loud (one of my favorite pre-outing hype songs) and finished getting ready (by that I mean, danced around my apartment). By the time my jam session was over, it was 7:20 or so, and I still hadn’t heard from Jason. I texted him to check in, and he replied by saying he was 5 minutes away. Perfect. *Plays 7/11 again.*

By 8pm, Jason still hadn’t arrived. A small knot was starting to form in the pit of my stomach. Did something happen to him? Something better have happened to him! I called and he answered on the 2nd ring. He apologized profusely saying that he TRULY was 5 minutes away now, something had come up. I hung up feeling uneasy.

The next time I looked at the clock it was 8:30pm. I was angry. Where is this guy? And also the underlying thought, You should really just cancel on him and start to study. He’s wasting your time. I looked at my phone, and there was no missed text or call. I didn’t want to reach out again, because I had already reached out twice.  At that point I probably should have just started to study, but I had invested so much time in getting ready AND I had been excited about getting out of the house. My mind was no longer in a studying mood. I turned on the TV and against my better judgement, continued to wait.

8:45pm. 8:50 came with a text: “I’m almost there, I promise! REALLY, I’m so sorry.”

9:00pm. 9:15pm. These times came and went. I started to get more and more anxious, and felt more and more guilty. This JERK really isn’t coming, is he? OMG I should have just studied! I can’t believe I waited this long for him! Girl, what’s wrong with you! My brain was swirling with thoughts. This had never happened to me before. I mean, guys had been late for dates in the past, or even cancelled at the last minute, but never this weird, unsettling, “I’m 5 minutes away” multiple times, to no avail. The longer he didn’t show up, the more anxious I felt. See, Tewa, it’s THESE KIND OF BAD DECISIONS that will cause you to do poorly on this exam! How could you have given up this much of your day! Really? For a date with a random! You’re NEVER going to get the score you need to match derm.

9:30pm. 9:45pm. 10:00pm. At this point, I was no longer waiting for him or expecting him to show. I wasn’t studying either. My mood was so bothered, that I simply sat on the couch staring at the TV but not seeing anything, feeling more guilty, becoming more and more overwhelmed with self-deprecating thoughts and doubt and anger and disappointment with myself and…

10:11pm: “Hey Tewa, I SWEAR, I’m still coming.”

I lost it. I threw my phone across the room. I started to feel hot. My stomach was doing full-on gymnastics. My breathing became shallow and fast and I felt like I couldn’t get enough air. I was losing control. I started to shake and cry. The more I cried, the worse I felt and the worse I felt, the worse my breathing got and the next thing I knew, I was shaking and crying and gasping for air and feeling like something truly terrible was happening to me. The walls felt closer to me than they ever had before. I tasted metal in my mouth. I REALLY couldn’t breath. What is WRONG? OH MY GOD, am I dying?

Although this had never happened to me before, I figured I must be having a panic attack. I didn’t know how to stop it. I slid off the couch to the floor gasping and crying and crawled to the corner of the room where my phone had landed. All I could think to do was dial my best friend, the last person I had talked to before Jason. Her typically cheery tone immediately grew serious when she heard me. I couldn’t talk, but could only gasp and cry. Concerned, she asked me what was going on. Immediately, the familiarity in her voice started to calm me down.

As she stayed on the phone with me for the next 2 hours, I repeatedly told myself to close my eyes and breathe slowly, in my nose and out of my mouth. Eventually, I could breathe normally. My gasping and shaking was replaced my soft sobs as I told her the story. She listened, reassured me that I had done nothing wrong, and that everything would be ok.

Looking back, knowing what I have accomplished since then, I now know she was right. Everything was going to be ok. I remember being so disappointed in myself for waiting for Jason, or for being so upset when he didn’t show. In case you didn’t figure it out by now, that guy really never showed up. The truth is, my panic attack had little to do with him, or the date. It had everything to do with underlying stress and doubt surrounding my exam. In the last few years, I have gotten much better at managing stress and anxiety and learning to deal with things as they come and not leaving them to fester. There were times I also had to go to therapy (HEY, YOU! Yes, you. Go to therapy!). Of course, I’m still learning and growing every day. I’m thankful for amazing friends and family that keep me sane and grounded as I continue on this crazy path to becoming a Dermatologist.

Until next time,

Dr. Oye