I keep fainting: embarrassed and feeling bad

[mmcoffee]

I'm a first year medical student and I am very happy in school. I find it fun and interesting. But recently, whenever I have days where I go into the hospital to speak with patients, I get dizzy and sick. This happens when I see regular drainage tubes in patients in the ICU, doing observerships in the OR... I am ok when I watch youtube videos, but there's something about seeing it in person.

This is something I know I want to do, but I feel like my body won't let me. I'm afraid to talk to someone because my classmates are judgemental.

I know some people faint in the OR and I suppose that makes sense, but I feel like mine is a lot worse. Has anyone had it like this? Is there anything I can do to help alleviate the response?

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[Light at end of tunnel]

I worked through a similar issue earlier in the earlier parts of surgical rotations. I had to psych myself out of being psyched out...

I'd get light headed as well and would start to feel dizzy, but after a while I started talking myself out of the episodes.

I think you can get over this OP, with time and effort.

Rest assured, even seasoned residents (like a senior Ob/gyn resident I worked under) would faint occasionally. It happens to more people than you think, but you can't let it become your achilles.

Keep in mind that none of us were born to look at blood, pus, gore, etc. Its probably normal that you have this reaction to these types of unnatural exposures.

 

[mistafab]

Spend more time in person watching this stuff OP. Shadow disgusting cases.

 

[Doctor-S]

I'm a first year medical student and I am very happy in school. I find it fun and interesting. But recently, whenever I have days where I go into the hospital to speak with patients, I get dizzy and sick. This happens when I see regular drainage tubes in patients in the ICU, doing observerships in the OR... I am ok when I watch youtube videos, but there's something about seeing it in person.

This is something I know I want to do, but I feel like my body won't let me. I'm afraid to talk to someone because my classmates are judgemental.

I know some people faint in the OR and I suppose that makes sense, but I feel like mine is a lot worse. Has anyone had it like this? Is there anything I can do to help alleviate the response?

@mmcoffee ... if it's any consolation, many individuals have felt faint (and have fainted) when exposed to various sights, smells, sounds, procedures, etc. in medicine.

These individuals have included countless medical students and residents. Seriously, it happens to everyone. Feeling lightheaded/queasy/squeamish is a common occurrence in the profession of medicine although many medical students seem to be reluctant to engage in self-disclosure (e.g., "I felt queasy/dizzy when fill-in-the-blank") for fear of sounding weak, dismissed, or embarrassed, or whatever. So, kindly rest assured: you are not alone.

In time, you will grow accustomed to (and familiar with) certain things that currently cause you to feel lightheaded. You'll "be in the moment" and you won't be thinking about feeling lightheaded or queasy. Instead, your exposure to different things in medicine will increase and you'll become increasingly resilient and desensitized to the things that may have caused you to feel lightheaded and queasy in the past.

 

[Brahnold Bloodaxe]

Liveleak and WatchPeopleDie are your friends here, OP. Sounds like you need to firm up that 'ole constitution of yours.

 

[intubesteak]

You will eventually become desensitized

 

[Mad Jack]

I'm a first year medical student and I am very happy in school. I find it fun and interesting. But recently, whenever I have days where I go into the hospital to speak with patients, I get dizzy and sick. This happens when I see regular drainage tubes in patients in the ICU, doing observerships in the OR... I am ok when I watch youtube videos, but there's something about seeing it in person.

This is something I know I want to do, but I feel like my body won't let me. I'm afraid to talk to someone because my classmates are judgemental.

I know some people faint in the OR and I suppose that makes sense, but I feel like mine is a lot worse. Has anyone had it like this? Is there anything I can do to help alleviate the response?

This is actually something you can't help that may or may not get better with time. Fainting reactions go perceived injury are interesting, as they are the only common response to external stimuli that triggers a drop in blood pressure and heart rate (vagal) rather than an increase (sympathetic). It's thought that this was an adaptive mechanism that helped your ancestors stay alive by dropping their blood pressure when they perceived themselves to be wounded, thus preventing their bleeding out. Only way to temper such a response is through exposure, but just know that there is nothing to be embarrassed about, you have an adaptive strategy built into your genetics that simply happens to be maladaptive for your current career. Make sure you hydrate and eat well prior to any exposures, as dehydration and relative hypoglycemia can exaggerate such responses. Good luck!

 

[Mad Jack]

Fight, flight or ... faint? Why some people pass out when they see blood or feel pain

Some writing on the biological basis of the fainting response.

 

[marcelo12]

I'm a first year medical student and I am very happy in school. I find it fun and interesting. But recently, whenever I have days where I go into the hospital to speak with patients, I get dizzy and sick. This happens when I see regular drainage tubes in patients in the ICU, doing observerships in the OR... I am ok when I watch youtube videos, but there's something about seeing it in person.

This is something I know I want to do, but I feel like my body won't let me. I'm afraid to talk to someone because my classmates are judgemental.

I know some people faint in the OR and I suppose that makes sense, but I feel like mine is a lot worse. Has anyone had it like this? Is there anything I can do to help alleviate the response?

My coworker has hypoglycemia and she has a tendency to faint. She eats before every shift and that has helped a lot. Besides that I'd say more exposure is the way to go, get used to the environment.

 

[Goro]

Spend more time in person watching this stuff OP. Shadow disgusting cases.

You made me laugh out loud with that one, Fabbie!!!

 

[mmcoffee]

Thank you for your responses everyone, they were very reassuring. I can't see myself shadowing gross things given I have trouble speaking to patients who seem to be in the slightest distress, but I've decided to work my way up to the disgusting ones.

Would it be worthwhile to seek help from a psychologist or try anti-anxiety meds while getting acclimatized to a hospital setting?

 

[Stagg737]

Thank you for your responses everyone, they were very reassuring. I can't see myself shadowing gross things given I have trouble speaking to patients who seem to be in the slightest distress, but I've decided to work my way up to the disgusting ones.

Would it be worthwhile to seek help from a psychologist or try anti-anxiety meds while getting acclimatized to a hospital setting?

Seeking professional help wouldn't hurt, as they could help you address any underlying mental health issues like anxiety or phobias before you start med school (which are things that can make med school significantly worse than it would be otherwise).

 

[ridethecliche]

Can you desensitize by watching case videos etc?

 

[OrthoTraumaMD]

Thank you for your responses everyone, they were very reassuring. I can't see myself shadowing gross things given I have trouble speaking to patients who seem to be in the slightest distress, but I've decided to work my way up to the disgusting ones.

Would it be worthwhile to seek help from a psychologist or try anti-anxiety meds while getting acclimatized to a hospital setting?

Yes! Psychologists can guide you in terms of exposure and your reactions --almost like treating a phobia.

If it's any consolation, I'm an attending ortho trauma surgeon and I recently almost fainted during my own case. Well, not from fear, but because the thermostat broke and it was like 80 degrees, and the smell of the blood got to me. I actually had to finish the surgery sitting down because I was scared I would pass out. So it happens to all of us, even years later. If you really love med school, you will find a way around it. Desensitization is key.

 

[TheFutureFatMan]

I'm a first year medical student and I am very happy in school. I find it fun and interesting. But recently, whenever I have days where I go into the hospital to speak with patients, I get dizzy and sick. This happens when I see regular drainage tubes in patients in the ICU, doing observerships in the OR... I am ok when I watch youtube videos, but there's something about seeing it in person.

This is something I know I want to do, but I feel like my body won't let me. I'm afraid to talk to someone because my classmates are judgemental.

I know some people faint in the OR and I suppose that makes sense, but I feel like mine is a lot worse. Has anyone had it like this? Is there anything I can do to help alleviate the response?

This is going to sound stupid, but honestly try to get some food on board. Something with a little sugar, it will help.

 

[Mad Jack]

Thank you for your responses everyone, they were very reassuring. I can't see myself shadowing gross things given I have trouble speaking to patients who seem to be in the slightest distress, but I've decided to work my way up to the disgusting ones.

Would it be worthwhile to seek help from a psychologist or try anti-anxiety meds while getting acclimatized to a hospital setting?

The sorts of meds that typically are used in treating anxiety can actually make this issue worse, as they temper a sympathetic response but make a parasympathetic one stronger. This is a specific phobia, so the only real way to deal is exposure therapy, but most psychiatrists won't have a real means of exposing you to this sort of stimulus to desensitize your physiologic response. You're just going to have to get in there and get exposed to these things over and over again until your body stops responding. You might even pass out a few times, but know that we've all dealt with fainting colleagues and co-workers, it's not a big deal.

 

[muhali3]

Try maximizing the variables that are in your control: proper hydration, being well-fed, proper sleep, don't lock your knees.

 

[RangerBob]

I agree with the desensitization technique--it will get better with time. Otherwise, hydrating will help a lot. And, you can do what fighter pilots do and wear really tight tights under your pants--it helps them withstand another 1-2G's. (Note these are actually specialized tights, and I'm not sure how comfortable it would really be to use them)

If just talking to patients makes you feel faint, consider sitting while talking with them (if you're not sitting already). Or, consider asking people to role-play with you--it helps a lot to do practice interviews, so I don't see why that wouldn't help you with talking to patients.

If you have a mentor, ask them if you can just sit down and chat with some of the patients. And I mean just chat--about weather, sports, etc. Basically start simple, in the shallow end so to speak. Preferably go to a VA--those guys (some ladies too!) have tons of stories to tell and won't mind spending the better part of the day talking with someone.

 

[girlofgrace7]

We've all been there, but some people get lightheaded more easily than others. If this is something that ONLY happens with blood, etc., a psychologist may help these episodes (or you can do a little exposure therapy of your own). If you're someone who tends to get lightheaded in other situations, there are lots of things that can help: drink water until your urine is clear, eat a salty snack beforehand (one neurologist I know recommends a dill pickle every morning to our teenage patients who pass out), remember to eat and drink regularly, and move your knees when standing. If observing or taking a patent history, sit down if you are able to. Also, do not be ashamed to step out of sit down in the middle of the floor; believe me, surgeons/scrub nurses would much rather you do this than deal with you contaminating a sterile field or dealing with your head injury from falling. Also, try not to focus on the blood or whatever makes you feel faint. Consciously think about something else or turn away for a second in those situations.

 

[yersinia_pestis]

Thank you for your responses everyone, they were very reassuring. I can't see myself shadowing gross things given I have trouble speaking to patients who seem to be in the slightest distress, but I've decided to work my way up to the disgusting ones.

Would it be worthwhile to seek help from a psychologist or try anti-anxiety meds while getting acclimatized to a hospital setting?

Definitely. Also, one of the great things about being in medical school is that you have access to clinical faculty. You can probably find one who is willing to help you actually increase your exposure under more "controlled" conditions so you can start working on desensitizing. Also, I think a lot (if not all) medical schools have a sort of stash of clinical faculty that are on a short list to help students who have to get better at their clinical skills. Perhaps they can also give a hand to students in situations such as your own? Worth it to ask, methinks.

But also, grabbing some mental health help will be beneficial, maybe not just for this particular issue but for all things medical school.

 

[grapefruit17]

I'm a first year medical student and I am very happy in school. I find it fun and interesting. But recently, whenever I have days where I go into the hospital to speak with patients, I get dizzy and sick. This happens when I see regular drainage tubes in patients in the ICU, doing observerships in the OR... I am ok when I watch youtube videos, but there's something about seeing it in person.

This is something I know I want to do, but I feel like my body won't let me. I'm afraid to talk to someone because my classmates are judgemental.

I know some people faint in the OR and I suppose that makes sense, but I feel like mine is a lot worse. Has anyone had it like this? Is there anything I can do to help alleviate the response?

super late reply, but we had a girl faint during an OR surgery and pass out in the sterile field.

We also had a guy have a panic attack during an ortho surgery and have to literally sit down on the OR, then exit the OR.. it happens, OP. Don't feel embarrassed. Even a good friend of mine it happened too. We were assisting stitching up a particularly nasty laceration, and he had to exit the room while I finished because there was so much blood. But hey, were both doing psych lol. I don't faint/feel lightheaded but blood/pus/poop I really don't like to work with at all. Hence, psych.So theres def options for you out there.

 

[NontradCA]

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[JonQ]

Same story here. Was at a burn unit and saw them removing necrotic skin from an entire leg.
I tried to stay tough and watch the entire procedure but the physical sensations of nausea and dizziness became too much. The surgical mask and clothes seem to suffocate me and it became incredibly hot.
I stepped out into the corridor for a few minutes and recovered myself...them came back in later.
The surgeons were really cool about it, didn't mention it at all.

The next time we walked through the burn unit and looked at patients it was a little easier.
I guess desensitization and exposure is all thats needed.

Some students are incredibly tolerant to such things from day 1 though. I remember 1 girl asked the surgeon if this one patient was going to die (he had 80%+ burns, unconscious, blood coming from his nasogastric tube, had already been defibrilated once that day). The surgeon said yes, he was likely to die.

I kept thinking...what if the patient heard the doctor say that..what if he wasn't fully unconscious and heard people talking about him about to die.
Well, he probably was far from conscious so thats illogical..but still I felt bad.
The next time we came, his room was empty but I didn't feel shocked. With injuries so severe it was the likely outcome.

Hmm...writing this post was tougher than I thought, but repeating these events from memory and visiting more patients will help desensitize.
When you see a very experienced surgeon they can appear quite callous, but I guess thats necessary. If I was sick, I'd rather have a doctor do the procedure quickly and effectively rather than start to cry or feel bad.

 

[kb0275]

Have you tried using ssris? I didn't even know ms1 were in the hospital until third year. (Incoming ms1)