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To the editor:
The journey to receiving a medical degree is marked by moments of incredible stress, with few more demanding than the MCAT and USMLE exams. Students spend many caffeine-fueled months preparing for an ominous day of reckoning, whose fateful moments of testing seemingly dictate their future vocation. A poor showing is a devastating prospect.
I began preparing for the MCAT with high hopes of soaring success. Within 2 months of the exam, I experienced my first heart palpitation, and my priorities quickly shifted. A few moments of rapid googling confirmed my suspicions but did little to relieve my anxiety. For the next week, I experienced 20–30 palpitations every day, in a positive feedback loop of stress and palpitations. A visit to the cardiologist and resulting Holter monitor were able to break the compounding cycle.
Anxiety-related heart palpitations are the most common type.1 They demonstrate the ability of stress not only to affect the mind but also the physical body. As an aspiring medical student who thoroughly admired the fortitude and competence of physicians, palpitations were an unavoidable reminder of my limitations. I was human, as are all doctors, and stressful experiences genuinely affect us even when we do not notice.
Heart palpitations afforded me more than insight into my stressful reality. They granted me the experience of being a patient. During that time, the body that I had instinctively trusted for so many years had become no longer trustworthy. I was uncertain about the nature of my palpitations and the future of my health.
As a medical student, I have encountered many patients in similar circumstances. The uncertainty in their eyes and worry on their faces feels familiar as I participate in their care. The occasional PVC subtly reminds me of my experience and sparks a swell of empathy. As I continue in my career, I intend to have grace for myself and for others, for stress or distress, high-stakes exams, or unhappy patients. I would encourage readers to do the same.
John Coggins, BS
University of Texas Medical School
University of Texas Medical Branch
Galveston, TX
REFERENCES:
1. Pedrinazzi C, Durin O, Bonara D, Inama L, Inama G. Epidemiology, classification and prognosis of palpitations. G Ital Cardiol (Rome). 2010 Oct;11(10 Suppl 1):5S–8S.