my life, my pace

Chief Complaint
“I’m stuck in a rut.”

History of Present Illness

The patient is a 20-something-year-old woman with a 20+ year history of schooling, beginning when she was 5 years old. The patient is enrolled in an MD/PhD program and is currently in the process of completing the PhD portion of the program. Having finished all of her graduate coursework, she is currently in the research phase of graduate school, which seems to have stalled due to complications with her major professor as well as with her experiments. She expresses frustration at the mention of her major professor, who seems to be a major source of annoyance in her life. Her frustrations started after she passed the USMLE Step 1 and began her graduate work in the lab. At first, she was glad to be in the much more relaxed environment of graduate school, but her frustration mounted as her major professor put her to work doing meaningless tasks for him because he was too lazy to do them himself. Not only did he refuse to help her develop a thesis project, but he kept her so busy with his stuff that she had no time to develop her project on her own. In addition, he refused to consider any of her ideas—as long as they did not agree with his views, she was wrong even though his ideas were oftentimes completely illogical. This pattern continued until the present day, with her only having begun on her thesis work in January 2006 only to have the experiments fail miserably. Meanwhile, her major professor continues to make her do his work for him while he surfs sports news and plays video poker all day. She denies being lazy. She also denies any procrastination or overreaction. She has no prior history of such frustrations or of being stuck in a rut.

Past Medical History
None

Allergies
NKDA, extremely allergic to hypocrites, mediocrity, sand people

Medications
None

Family History
Non-contributory

Social History
The patient got married recently and has “crazy” in-laws, which are another source of a significant amount of annoyance in her life. She describes them as being normal enough, with a change occurring on their wedding day, when the trouble seemed to start. Since then, the situation has only become worse as she is currently embroiled in a virtual tug-of-war with them over her husband. During her free time, she enjoys watching House.

Review of Systems
The patient reports feeling quite satisfied with life prior to the onset of the current symptoms. The patient emphasizes that she is not dissatisfied with her current life, but feels that she needs to finish up her research so that she can return to medical school, which she, believe it or not, misses.

Physical Examination
Unremarkable

Labs
Unremarkable

Assessment
The patient is a 20-something-year-old woman with a history of extensive schooling now presenting with frustration at her current lack of progress consistent with being stuck in a rut.

Plan
This condition is quite common in the US population and is not limited to students in graduate school with lousy major professors. For example, it has also been observed in people dissatisfied with their jobs, those dissatisfied with their personal relationships, and those in various other stages of schooling. Successful treatment requires removal of the cause(s) of dissatisfaction, including but not limited to changing professions, changing friends/significant others, and changing/finishing schooling. In this patient’s case, the logical course of action is to determine why her experiments are failing and to design successful experiments, which will allow her to finish her project and return to medical school. This treatment is a long and difficult process not without side effects, with the most common being increased frustration, stress, and long hours at the lab. There is also a risk of failure to design successful experiments despite considerable effort, which will require the patient to design a completely new thesis project and will significantly lengthen the patient’s recovery and time spent in graduate school before returning to medical school. It is hoped that this particular case will not follow this course. The patient is reassured that she is not doing anything wrong and is encouraged to continue going about her life at her pace. The patient is also advised to avoid other sources of frustration in her life, especially her in-laws. The patient was advised to consider counseling to work through her frustrations during this treatment, but is unable to take time off from doing her major professor’s menial tasks at lab to attend sessions. She will instead be writing in a blog, a promising new alternative therapy for this condition, which does not require her to take any time off since it can easily be done while the patient is at the lab.

DISCLAIMER: The views expressed on this website are those of the patient’s and not of her institution or of anyone or anything else for that matter and belong to the patient.  Please do not steal her material as it may delay her recovery as she just may hunt you down.