Last November, I was checked into a Cambridge ER after a suicide attempt. I sat in a hospital gown in an observation room and considered dreams that might be crushed by this interference with my schoolwork. The midterms I had bombed immediately after a friend’s suicide attempt earlier that term would be nothing compared to the risks of not completing the semester. Fragile though I was, I could not imagine a life without a career in medicine. Before I left the emergency room for an inpatient psychiatric facility, I told the nurses and doctors they had inspired me to continue my studies to become a doctor to help people in situations like mine. Their patience with my hysteria amid countless other even graver cases moved me to tears.
The IV sitting in the crook of my arm was nothing new to me. As a child, I went to the hospital for diseases ranging from pneumonia to anemia to anorexia. Many times, doctors had snapped at me when I couldn’t remember my medical history or when my veins yielded too little blood. These doctors were the ones who made me fear ever returning to the hospital, not because hospital visits indicated once again failing health, but because their dismissiveness made me feel unworthy of the care they would give me.
這種情況不僅限於醫生。在哈佛的多數醫學預科（Pre-med）環境裡，我看到不斷地助長，甚至鼓勵，這種態度的環境。急診室需要醫生和護士相互協作，然而每學期我都看到了同樣的模式：學期初期，學生上如 Life Sciences 1a（哈佛的基礎生物課）和 Chemistry 17（哈佛的基礎化學課）等大課，組成小組，互助學習，一起複習功課。然而，第一次考試結束、拿到成績單後，互助小組就逐漸瓦解了。學生們更加忙碌了，他們更加努力讀書，也更加封閉自我。學業超前的人不會幫助落後的人。教授 Office hours（課後輔導）因此變得非常擁擠。無人願意讓自己的分數低於標準，因此有困難的學生會落後越來越嚴重。
This phenomenon is not limited to doctors. I see this attitude growing, even encouraged, within much of the pre-med community at Harvard. The ER requires that doctors and nurses work together, yet every semester I see the same pattern: At the beginning of the term, students in large classes like Life Sciences 1a and Chemistry 17 form groups, all intent on helping each other study and check problem sets. But then, after the first exam, when grades are returned, the mutual support dwindles. Students get busier, they work harder, they shut themselves off. Those who excel stop helping those who fall behind. Office hours become packed. Nobody wants to fall victim to the curve, so struggling students fall farther and farther behind.
我看很多朋友會為朋友慶生，給他們送禮物，然後卻在對方學業遇到困難時忽略這些朋友。當朋友們在「weeder class」（「淘汰課程」，意指非常難的課程，用於淘汰不合適的學生，這些學生會像雜草一樣被「割除」）中需要幫助時，這些朋友成了阻礙，因為這是追求 GPA 滿分 4.0 道路的絆腳石。唯一關心我長期請假情況的人是我的課後討論小組的助教，我每次都會「虔誠」地去 office hours 向他請教問題，他對我的幫助與情感支持，我一直銘記於心。在我住院期間，僅有少數朋友注意到我不在。其中沒有一位是醫學預科班的同系朋友。
I watch so many of my friends celebrate birthdays and give gifts to friends, and then ignore those same friends the moment they struggle academically. When friends ask for help in a “weeder” class, they become a mere distraction, a stumbling block to be avoided on the search for a 4.0. The only person to even ask me about my prolonged absence was a peer study leader whose office hours I attended religiously, and whose help and emotional support I am forever grateful for. During my hospitalization, only a handful of friends noticed I was gone. None were pre-meds.
我另一個朋友被送到急診室。我的期末考試快到了，所以我告訴她，她得等到考試結束後我才能去看她。我給自己出了個餿主意：我現在可以忽略她，我只要之後在醫生這條路上多做點好事就可以了。將來某天，也許是 10 年或 15 年以後，我能為一位服藥過量的自殘病人縫合手腕上的傷口，幫他開藥。將來某天，我能在朋友壓力過大，精神崩潰時，安慰她。然而，如果醫學預科班有教會我什麼事，那就是不要同情心泛濫。給出的每一份善意都有風險，而在上 Chemistry 17 的期間，我把朋友獨自丟在醫院。這是我永遠無法原諒自己的事情。
Then another friend of mine was rushed to the emergency room. I had finals coming up and told her that she would have to wait until my exams were over. I told myself something stupid about doing more good down the road as a doctor if I ignored her. Someday, 10 or 15 years in the future, I would stitch up the slashed wrists and give drugs to combat the overdose. Someday I would be able to comfort my friend after she collapsed under the pressure. But if being pre-med taught me anything, it was the limits of compassion. Every spare kindness is a risk, and while studying for Chemistry 17, I left my friend in the hospital alone. This is something I can never forgive myself for.
Harvard pre-med classes don’t pretend to be easy. You’ll skip parties, you’ll tell your friend you can’t catch up with him tonight even though he’s been begging you. They never tell you that you’ll have to ignore your friends as they spiral lower and lower. You have to stop bringing your sick friend the lecture handouts, because if they were taking the course seriously, they’d push themselves to go to class, right? And you’ll tell yourself that this is because you want a career that helps people. There are some who can power through, who will help their friends even when it takes time away from their own studies.
但是這種情況並非如教授所希望的頻繁。大家對這件事的沈默使得這問題更加惡化。所有人不止要面對考試成績跟心理健康都能達標的壓力。沒有人願意承認自己失敗了，每個人都假裝很累但很開心，因為如果你想進醫學院，你就不能崩潰，你得學習得更好，而且一旦你示弱，那麼醫學預科可能就不適合你。因此我並未告知任何人我在精神病院治療了 2 個星期。
But this does not apply as widely as professors would hope. Much of this problem is worsened by the silence surrounding it. All the stress of making the curve applies to mental health as well as test scores. Nobody wants to admit they failed, and everyone acts exhausted but happy, because if you really cared about getting into med school you wouldn’t have breakdowns, you would have studied better, and if you show any weakness, being pre-med probably isn’t for you. And so I spent two weeks in a psychiatric hospital and told no one.
If you finally break down after trying so hard like I did, it feels like failure. Anything that deviates from the “traditional” pre-med track is a failure. If you take physics through a different university, if you take organic chemistry after graduating, if the pressure of pre-med is too much and you stop that track, or if, God forbid, you leave the STEM field altogether, pre-meds look down on you. I looked down on myself when I realized I might not have the emotional strength to stay on the pre-med track, at least at this university.
So of course I didn’t tell any of my pre-med friends about my suicide attempt. Future doctors don’t do that.