Mental Health: May 2019

Burnout. Resiliency training. Mindfulness. These are buzzwords that are ubiquitous in the training of housestaff, a response to distressing stories of resident suicide in recent years. In honor of Mental Health Month, we dedicate our May theme issue of in-House to the mental health of physicians-in-training.

Shining a Light on Medical Student and Resident Depression
Alison Cesarz, MD, psychiatry resident at University of California San Diego School of Medicine

in-House Readers’ Choice Award

Alison Cesarz, MD

I am a psychiatry resident at the University of California San Diego and my path to psychiatry was a winding, yet inevitable one. I was born and raised in the suburbs of Chicago and as a youth loved to read, write, and draw. I was a bifocal-ed introvert whose favorite thing to do was get lost in a book, particularly in the mind of a narrator. If you asked me what I wanted to be when I grow up, I would say, “An illustrator.”

I attended college at Washington University in St. Louis where I found my tight-knit family of fellow weirdos running track and field and pursued my early interest in the mind and language studying psychology and Spanish. When I felt bogged down with premedical science courses, I found refuge in the passionate, tragic stories of Spanish literature.

My decision to pursue medicine occurred while working at a shelter for neglected children one college summer when I witnessed a visiting pediatrician’s interaction with the children. I was struck by how kids who had been too scared to speak for weeks were suddenly empowered to share their physical complaints with the doctor and eagerly spoke her as she intently listened to them and validated their ailments. I entered medical school thinking I’d pursue pediatrics, but on this and every rotation I was more interested in listening to the stories patients told about their lives than in their medical pathologies. My childhood pastime of exploring a narrator’s mind became a reality as I engaged with patients and became privy to their inner worlds. For me, there was no boring day on my psychiatry rotation and my decision to pursue the specialty was solidified.

Of course, the journey I took through medical school to arrive at this conclusion was a very difficult one, wrought with periods of what I would later learn was depression. Luckily I made it through and was elated to be accepted to my current residency, where I was originally drawn to by the acute pathology, opportunities to train at both University and VA hospitals, and experience working with the homeless and Mexican immigrant populations. In residency, I continue to be a strong advocate for improvement in medical student and resident mental health because I believe there remains a high degree of stigma around mental illness within the community of medicine, yet it is so common and no one should suffer alone. I am open and accessible to sharing my treatment journey and collaborating on ideas for improvement in this area.

Looking forward, I am interested in completing a child and adolescent psychiatry fellowship after residency. Informed by experiences working at the child shelter in St. Louis, completing an away rotation at Bellevue Hospital’s child psychiatric emergency department, and treating college age youth in San Diego, I am interested in working with vulnerable child and adolescent populations during my career. My dream would be to continue practicing in California where I find joy running the mountain trails, swimming in the ocean, camping in the desert, living off of fish tacos, and of course, writing.

Why are the arts in medicine important to you?

I subscribe to the definition that art is a human’s method for making order out of chaos. Medicine can be chaos for both patients and providers. Just as science helps us approach a patient layer by layer, dissecting a disease process and compiling illness scripts, art is our tool for bearing witness to the many colors and threads that make each patient experience (hospitalization, trauma, remission, or recurrence) a unique tapestry. It also provides us with a scaffolding for the raw emotional impact medicine has on our lives as providers and a structure for connecting with others on difficult topics. Simply stated, it allows us to illustrate our patient’s stories and our own.

Why do you write?

“I write to taste life twice.” –Anais Nin

Since I was a young girl I’ve kept a diary. There are many volumes floating around, most in my parents house and some with me in my apartment. From time to time I’ll page through my old ones to self reflect or reconnect with a younger self. Writing is the thing that has always brought meaning to my life. It is the medium for my truest, purest voice. I will forever write to build awareness around my passions, chronicle my adventures, and share my inner world with others.