Plasticity, Neuronal and Otherwise

** work in progress, but I figured it has been a long time since I updated this dusty, old thing..

As an enamored fanatic of the neurosciences, plasticity is vocabulary long since integrated into my lexicon (pfft, Hebbian learning? I can recite the motto even in REM). The notion of this incredible neuronal adaptability is something that we have repeatedly covered in my undergraduate lectures, in excited discussion, and read about in the fields of current research. And while I have always known this, experiencing the first year of medical school truly allowed me to understand this extraordinary plasticity we all possess.

Interestingly, I am currently in the unique position of a temporal triple point. Having the honor to serve as the class of 2018 orientation coordinator as well as having recently moved into a house of rising third year medical students, I am in a unique standpoint to observe and juxtapose the past, present, and future. I feel like I am peeping through blurred lens – smudged by time and rosy reminiscence – with such clarity as I interact with the incoming students, assuaging them of their various anxieties and providing them with the advice that I had been given not so long ago. I remember so distinctly that excited yet nervous apprehension that came with starting a completely new chapter of life – that unsettling fear of the next four years that could be simultaneously incredible yet devastating. Having been in these shoes for a full academic year, I now realize the perspective and meaning when my orientation coordinators assured me to fret not of my numerous and quickly-growing questions about surviving medical school life, the curriculum, the classroom atmosphere, the difficulty, and so the list grows.

All will come in good time, how true that advice was.

Looking back, I see the fresh excitement of my own phantom self in these eager underclassmen. I realize these bubbling, brimming anxieties and fears that I had about the obstacles and potential failures were, in fact, usually not as bad as I had imagined. The thing is, most of us all got through the first year of medical school relatively unscathed. I passed all my classes (albeit not with all my ideal grades), and I have learned quite a lot. Yes, it was hard, and yes, I definitely did not feel ready at first, but time went by so quickly that before I knew it, I had adapted to this new rhythm of life. With every panic attack near each theme’s final – so certain that I was for sure going to fail this time – I have slowly come to understand to focus on the big picture and not overemphasize the importance of one small step of the long path of a physician. See the forest and not the trees.

Of course, saying that is so much easier than executing this calm zen-ness.

I remember my upperclassmen providing me with the similar placation throughout the course of my first year, and it was nearly impossible for me to wrap my mind around. At first, it was impossible for me to believe that I could not score the best of the best and still turn out okay. Then, it was impossible for me to accept that I could manage all of this academic stress along with the struggles in my own personal life. But, despite all my self-imposed impossibilities, I have survived!

It is not that I thought myself to be less than who I was, but it was simply the fact that I adjusted to this different lifestyle and learned to adapt to new stresses. Five-week themes at first seemed too rushed, but by the end of the first semester, they seemed completely normal. I was so nervous when I stepped into my fist clinical skills to meet the standardized patient (so nervous that I sweated buckets just to squeak a high-pitched hi), but by the third time, I was curious to see what kind of story they would have for me. It wasn’t the scenario that had changed or gotten easier. I had changed.

Without even realizing it.

Seeing that familiar sense of worry through the numerous questions of these incoming students, I am reminded that it was not so long ago I was in the position of infancy – the life and knowledge of a quarter of medical school still largely unknown to me. It is in these moments that I remind myself how much I have grown in such a short period of time.

One of the disadvantages of existing in the present is that is extremely difficult to see where you are. It is only when we look to the past can we track the progress and progression of our decisions and behavior. As a perpetual worrier, I tend to comb through any errors and mistakes that I have made, the intent to improve and correct the progression of my path; every screenshot of my life is scrutinized for incompetence and inadequacy to the ideal. Being surrounded by incredibly talented peers and mentors, it is so hard yet important for me to also recognize the achievements and milestones that I have made.

At the same time, looking to the future helps us set desired goals and sustain our motivations. Getting to know my delightful roommates has not only given me an idea of what my imminent close-coming future will be (and thus helping me remind myself it is not an impossible task), but it also has shown me how – human they are. When I first started medical school, I remembered how amazing and incredible the second years appeared. Having completed medical school and coming closer to where they are, I have realized how similar we are. Slowly, this daunting year before me feels less impossible to scale. Understanding that they are not so different from me has amazed me of how quickly our mind adjusts to difficulty. Right now, the thought of two-week themes seems terrifying and overwhelming to the me right now, but I had thought the same of the four-week themes initially. In comparison, my current second-year roommates regard the two-week themes as something that is completely manageable. In the short span of one year, their minds have adapted to prioritize and triage the most important things in their busy schedules. With shorter study times and more information to absorb, time management and focus skills quickly sharpen and become enhanced.

The level of maximum productivity, I have realized, is dependent on necessity. Because we are all inherently lazy creatures – desiring to achieve the most with the least amount of effort – we are only as productive as we need to be and not naturally set at the maximal potential that we can achieve; it is with the need to more efficiently utilize our resources that we raise the bar of productivity and focus. It is so amazing to me how quickly this process can occur. The flexibility and adaptability of the human brain truly is an amazing mechanism to behold. And with the immense potential hidden within the neurons underneath my skull, I feel a breath of hopefulness towards second year and raise my metaphorical glass to the endless possibilities of a promising future.