Crop-Rotate Your Mind

Name: John Eberly, Jr., MD

Medical School: University of South Carolina School of Medicine

Year: Fourth Year*

*While Dr. Eberly is now an MD, he answered these questions as a Fourth Year.

  1. What is your #1 study tip?

Workless work leads to restless rest. It’s easy to get trapped in a pattern of “working” only to daydream about the rest you wish you were having, then “resting” only to worry about the work you wish you were doing! If you’re not studying, call it what it is. End your day and go home. Two hours of true, focused, undistracted study are better than six hours flipping through sweet nothings on social media and habitually refreshing the email inbox while starring vaguely at PowerPoint slides. Likewise, an hour of intentional rest is probably better than three hours “playing hard.”

2. How do you keep yourself motivated or get out of study ruts?

Playing music. Exercise. My wife’s words. Friends. A well-made cocktail. My son’s tiny fingers. Vespers. Anything beautiful that causes my heart to say “Yes.”

The thing about beauty is that it cultivates life-giving wonder while also mysteriously heightening an awareness of ugly things that are not the way things should be. So, what causes the heart to cry “No” (suffering, injustice, etc.) can also be strangely motivating.

As for study ruts, I “depart and return.” The medical mind will slowly close if it only studies medicine. Farmers rotate crops because it gives the soil time to heal. Crop-rotate your mind.

3. What does your daily study schedule look like?

I’m currently a post-interview fourth-year medical student with a baby at home, so “daily study” in this season looks different than previous years. Most of my daily work is spent reading and writing. I’ve been encouraged by some recent and upcoming publishing successes, so I’m trying to build on that momentum before residency starts.

Variable schedule aside, the pre-dawn morning is my stillpoint — an unchanging ritual of candlelight, prayer, coffee, an orange, two pieces of toast, and engaging something non-medical before beginning the day’s work (this morning it was fun facts about beets — can’t make that up). Find your stillpoint.

4. What would your classmates be most surprised to learn about you?

Probably my obsession with Beauty, and AHEM. “AHEM” stands for Ars, Humanitas, et Medicus — “Art, Humanities, and the Physician.” A few friends and I started this medical humanities group as M1s. We gave weekly “lectures” on everything from philosophical theology to typography (doctor’s handwriting being what it is). We attended “Arts and Draughts” at our local art museum, and even played ridiculous covers of pop songs before exams to try and alleviate some of our collective pre-test anxiety. After returning from a one-year leave of absence in Duke’s Theology, Medicine, & Culture Fellowship, AHEM evolved into my current project, Phronesis.

5. Who are your mentors?

Over the last two years, Kenny and Shari McWilliams (music producer, lifegroup leaders), Chad Rochester (high school English teacher), John Paulling (pastor), Sammy and Alyssa Rhodes (RUF, bourbon connoisseurs), Matthew Lenhard (OB/GYN, M4 advisor), Jocelyn Harmon (pediatric hospitalist, co-leading Phronesis with me), Farr and Kimberly Curlin (palliative physician, bioethicist, co-director of the Theology, Medicine, & Culture Fellowship at Duke), Warren Kinghorn (psychiatrist, theologian, also co-director), and Martha Carlough (family physician, Ignatian spiritual director).

Lists and parentheses aside, these relationships are marked by candor, transparency, laughter, drinks, and truth. In most cases, these people are not just mentors, but dear friends.

6. What is the best advice a resident/attending gave you?

“A gentle answer turns away wrath,” and to follow up “I don’t know” with “Will you teach me?”

“Gentle answers” are about tone and cool. It’s difficult not to get flustered if you’re on the receiving end of a pimping session from an upper-level or an irritated rant from a patient. Slow, thoughtful, respectful words (note: not sugary or servile words) are disarming. They show equanimity.

While it really is ok to say, “I don’t know,” it can be perceived as apathetic or lazy. Following up with, “Will you teach me?” not only honors your inquisitor, it communicates humility and curiosity.

7. What book would you recommend to all medical students?

Paul Kalanithi’s When Breath Becomes Air. I know it’s becoming a medical book recommendation cliché, but it’s truly stunning. Kalanithi captures the experience of being human in a ridiculously potent, severe, and truthful way: the struggle with wisdom, knowledge, faith, doubt, science, grief, human existence, aspiration, sickness, philosophy, beauty — all the terror and hope and mystery of it all — the embodied, participatory epistemology of being a body and yet also a soul, not merely a brain but not just a spirit. Kalanithi doesn’t quite attain the “bio-metaphysical” heights he seeks (who among us can?), but he gets pretty damn close.

8. What would you be doing if you weren’t in medical school?

Probably seminary or further training in philosophy and theology. Reading, writing, learning, and teaching — maybe lean all the way in to my fascination with Beauty. But I get restless if I’m not doing something with my hands (hence my choice of a specialty with surgery — I’m enjoying and taking advantage of the free time I currently have to write, but I miss the OR). So, I would have to do something where both my mind and my body are engaged. Maybe I’d reach out to Wendell Berry or Makoto Fujimura and beg them to let me apprentice myself to them…

9. What is the most important lesson you’ve learned so far in medical school?

In A Severe Mercy, Sheldon Vanauken says that love, like any good endeavor, requires a conscious embrace of both “the heights and the depths.”

The depths of medicine are deep indeed: suffering, death, a strange and unjust healthcare economy, the moral crisis of “the hidden curriculum,” misanthropy, burnout, etc. But the heights are high: the beauty of healing — restoring patients to right relationship with their bodies and minds, and thus back to their communities and the world.

Flourishing in medicine means holding all these things in a wild tension — practicing habits of attention to both “the heights and the depths.”

10. What was your most memorable “first” experience in medical school?

Two experiences compete: First, about six weeks in, I vividly remember stopping at a red light near our medical school on my way home one night. I just stared into that red glow — feeling overwhelmed, scared, numb. I was literally “stopped.”

Second, I’ll never forget our first morning anatomy exam. Our anatomy lab is old-school. Brick walls. Dusty chalkboards. High, vaulted windows. The sunlight was beaming through the glass in great, angled pillars — illuminating our “first patients.” It remains a deeply important symbol for me, conveying the great privilege and responsibility of medical school — the literal illumination of the patient.

11. How are the topics of burnout, wellness, and work-life balance addressed at your school?

We have a PALs program (“Peer Advocate Liaisons”) to create safe spaces for students to share struggles. Our student-life folks are sensitive to spotlighting mental health resources, school-spirit events, and the like. And there are encouraging grassroots small groups like Phronesis that we’ve formed on our own accord to engage these topics.

While I’ve certainly seen the burnout-wellness-work-life conversation addressed at our school, I fear we’re missing the mark. Wellness can’t be achieved from lectures, individual self-help measures, or “arranged marriage” mentorships from administration. Wellness requires something more like friendship, community, belonging, and vocational purpose — it requires meaning.

12. Do you have any tips on being on-call?

“Shake the tree.” Residents on-call are (understandably) split between something like “Dude, go get some sleep. You’ll pay your dues later,” and “Follow me if you want but stay out of my way.” That means that your resident may actively “release” you or subconsciously forget you. Either way, don’t disappear into the library to inevitably fall asleep. Find a patient who happens to be awake and exchange stories. Ask the ED nurses to teach you a few things. No med students on-call in L&D? Get up there and deliver a baby! Shake the tree. You’ll be surprised what fruit falls.

13.What is your Step 2 study strategy?

First, calm down. No matter what some subreddit or student-doctor-network echo chamber says, your life, worth, identity, and future aren’t reducible to your Step scores. They really aren’t.

Second, question banks. I did as many questions as I could per day, between patients or at home in the evenings.

Everyone is going to have their own strategy, but what I’ve found unites all of the successful strategies is place, routine, consistency, and honesty. Whatever you do, protect a place for it, do it daily, do it the same, and be honest with yourself over what you know and don’t know.

14. What patient will you never forget?

I volunteered to triage a patient introduced as “insane.” Significant psych history. Sexual abuse. She told me she had “like eighty” abortions. I remember my heart sort of breaking, not really knowing what to believe or what to say.

What is devastating — and why I can’t forget her — is that I came back to present her and immediately submitted to the caustic, behind-the-scenes habits of the call room. I went from heartache to laughing at cruel jokes made at this woman’s expense.

She ended up leaving AMA. People cheered.

I can’t forget her because I feel like I deeply failed her — not only professionally, but morally.

15. How did you decide what specialty to pursue?

First, OB/GYN is surgical. I loved the OR from my first scrub. Second, women bring a seriousness and self-awareness to the clinical encounter that I really respect and enjoy. Third, OB/GYN hosts some of the most beautiful (and most devastating) moments in medicine, demanding the proverbial thick skin of surgery alongside the tenderness and presence of primary care. Fourth, OB is ethically complex (particularly in so far as theology and culture are concerned), which answers my hope to be a sort of “mearcstapas” or “muddy-border-walker” — someone who crosses the murky boundaries of differing perspectives to try and speak between them.

16. What has been your most gratifying moment of medical school?

There are moments in the OR and on L&D that stand out. But truly, my most gratifying moments have been with Phronesis.

Phronesis (meaning “practical wisdom”) is an informal, monthly forum for exploring medical student formation. I created it in hopes that it might inspire a “parallel curriculum” that follows the medical student through all four years of education.

We ask ourselves two questions at every session, over drinks and few “assigned” readings: “With tonight’s topic in mind, how is modern medicine forming (or malforming) us?” and, “Given that formation, how should we then live and practice with wisdom?”

John Brewer Eberly, Jr. MD wrote this as a fourth-year medical student at the University of South Carolina School of Medicine. He is a fellow of the Theology, Medicine, & Culture Fellowship at Duke Divinity School, and is currently in research with the UNC Chapel Hill Maternal-Fetal Medicine Network. His writing has appeared in JAMAAMA Journal of Ethics, Academic MedicineFirst Things, Mere OrthodoxyDoximityand KevinMD.

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