Stress Case Study

The day started off well enough. Allison, an advanced veterinary student, got up early to run a mile and a half (instead of her usual 3 miles, but sleep was more important – right?) Since she was pressed for time, she stopped at McDonald’s on her way to the hospital for breakfast, reminding herself that she really should eat healthier tomorrow. But she was optimistic about the day, remembering the A she received the day before on her Infectious disease exam and how she had been the only one in the group to correctly diagnose the case presented in the problem based case study.

When she showed up at the teaching hospital, however, she was immediately put into a group of her peers looking at x-rays and trying to diagnose problems. When she was called on and failed to notice the abnormally sized heart of an eight year-old beagle and missed an obvious case of life threatening heartworm disease, she was embarrassed and found it hard to speak up for the rest of the rounds. “They must think I’m the class idiot,” she thought to herself.

Then it was time to see Nicki, a diabetic cockapoo. Allison was humiliated when the clinician had to correct her for mismanaging the insulin therapy of this case – fortunately before any damage was done. But he had corrected her before and this time, it was in front of two other students. “Stupid! Why can’t I remember that?” she chided herself.

Later that morning, she was involved in the euthanasia of Mrs. Paul’s beloved six year-old golden retriever, Maggie. The cancer was inoperable and Mrs. Paul was heartbroken, as were all of the students who had come to love Maggie. Allison stayed with Mrs. Paul as she wept and clung to her dog. The intensity of the situation was overwhelming. Allison was depressed about the events of the morning, and actually looked forward to getting to class.

But in her first class, Dr. Carter returned her Neurology exam and she was surprised to see a C. She thought she had at least gotten a B, but she really messed up on the section with multiple choice questions clearly designed to confuse the students! “I’ll never graduate if I keep this up,” she thought to herself. She resolved to study more for the next exam and really concentrated on Dr. Carter’s lecture on encephalitis.

“How did your day go?” she asked Kerry when she finally got home. Kerry, also a third year veterinary student, was Allison’s roommate and best friend.

“Great!” Kerry said. “I got to ride with an equine practitioner!”

“Wow, that’s fantastic!” Allison said, hoping to hide the tinge of envy she felt at her friend’s rare mentoring opportunity. “This seems to come so naturally for you – sure wish it was that easy for me.”

“What are you talking about?” Kerry said. “You’re a whiz at this. You’re going to be a great doc! Did you have a bad day, or what?”

“A bad day?” Allison said. “I’d say that’s an understatement. I feel like I got chewed on by a Rottweiler!”

After sharing the details of the day, Allison felt better until Kerry reminded her that their rent was due tomorrow. Once again, she had run out of money before she had run out of month! “I can’t ask my parents for more money again,” she thought.

That night, Allison couldn’t fall asleep again. Sleepless nights were getting to be the rule, not the exception. Thoughts of mistakes, poor grades, overdue rent and grief consumed her. “Maybe I’m just not cut out for this” was her final thought before she drifted off to sleep.

What can Allison do to better manage her stress?

Stop. Listen. Be nicer to herself.
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Acknowledge her emotions.
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Take care of herself first.
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