Confessions of A Sleep-a-phobic

Have you ever wonder how I worked 7 jobs while double-majoring at UC Berkeley, and manage to cook and entertain my friends at my college apartment regularly?

How I worked 2 jobs as a single mom medical student?

How I now as a PGY2, blog about personal finance, tutor USMLE, write books, give talks, and do podcasts and YouTube on the side? Someone joked that it seemed that I have a large career in personal finance and I do residency on the side. No, I can’t possibly do that. Residency, and especially radiology, is indeed an all-consuming endeavor. PGY training challenges each and every resident like myself in various ways: physical stamina (80 hour work week,) mental agility to learn new and massive amount of information, psychological fortitude to weather and yet try one’s best to help lessen the suffering of patients.

The simple truth to how I do all I do is a sad confession. I have not slept more than 4 hours continuously since I was 16, the year I immigrated to America.

Having 20 waking hours a day worked to my advantage when I, a fresh off boat immigrant, in English as Second Language classes, had just 3 months to prepare for SAT’s. On SAT’s, I scored higher than 90% of the American born kids.

Sleeping just 4 hours a day also worked to my advantage in medical school, allowing me to take great care of Mini Wise Money while working 2 jobs and performing at the top of my class.

However, as I get older, my high school guidance counselor’s words began to haunt me, “If you keep this up, you’d be dead by 40.” I turned 32 this year… I thought about increasing my life insurance to take care of my Mini, my parents, my partner, his parents, etc. …

At the kind and strong suggestion of my program director, I went to see a psychiatrist at last. He diagnosed me with Bipolar Type II (which was no surprise to me.) But what surprised me was how he phrased everything. He said it is amazing how much I was able to accomplish with an untreated bipolar for what seemed like started when my sleep issues began at age 16. He was incredulous at how I turned my illness into a tool to succeed beyond most people’s imagination.

In the positive spotlight he directs onto my symbiotic relationship with my bipolar disorder, I realized why I did not seek medical care for my sleep issues for 16 years…

My lack of sleep and my successes were a positive feedback loop without any checks and balances. My sleep-a-phobia was a vicious downwards spiral much like that of a work-a-holic. Because unlike most diseases, sleeping less and working more are incentivized and rewarded by our society.

To put it bluntly, I was killing myself slowly, gently, & happily.

I have a happy ending. I had a supportive family, I have an amazing residency program director who recognized that I needed help direly and told me that gave me time off to see the psychiatrist the day of. But how many of my dedicated colleagues have sad endings? Dr. Pamela Whible, who studied the subject of physician suicide extensively, quoted that doctors on average commit suicide 3x more than patients.

The demands of pre-med, medical school, residency, fellowship, and even attending physicians are truly inhumane… Ironically the most humanitarian people in our society who chooses to become health care providers are treated so inhumanely by the laws and regulations.

I have seen what medical school and residency does to me and my peers. While I was killing myself happily and gradually with my delusions and hypomania, some of my colleagues could be battling deep depressions, sleep deprivation and more. How can we expect sick, exhausted, depressed doctors to heal sick patients?

After my confession of my sleep-a-phobic 16 years of life (I slept 6.5 hours continuously for the first time in 16 years last night with one medication prescribed at my first psychiatric appointment), I invite you to join me in the Physician Support Initiative (P.S.I.), a grassroots movement to raise healthier, happier, and naturally more effective doctors. You can read more about P.S.I. here.