Medical school in Peru is a seven-year program during which the last (seventh) year of medical school is called the internship year, similar to the first year of residency in the United States. Interns are expected to work every single day of the year, despite having 24-hour shifts during the week. In January 2020, I began my internship in a pediatric service center. As the only intern on that service, I worked alongside five residents. Unfortunately, the paperwork to start the internship was delayed so I had to bring some of my documents with me during the first week of the internship. The documents included my transcripts and health certificate, both of which I kept in a folder. One day, I forgot my folder in the service center. I was so busy starting the night shift that I overlooked that I had left it behind until I found it the following morning. I was busy and tired. I did not think much of it.
Less than a week later, I was discussing a case with a resident after rounds. He asked me directly if I had obsessive-compulsive disorder (OCD). I felt my mouth getting super dry, and I began to sweat profusely, an intense sharp pain starting to form in my chest. I got flustered and did not know how to answer. At that time, only my mother, husband, and two close friends knew about my OCD. Later that week, another resident confessed (without me asking about it) that they had found my folder and read through it. I laughed nervously in response and changed the topic immediately. I tried not to make a big deal about it, but it only got worse. The residents picked on me a lot. I finally had the courage to talk with the attending physician about what happened, but it did not go well. He concluded that I brought the papers with me because I unconsciously wanted others to discover that I had OCD. It felt like I was being blamed for what happened to me. This was probably one of the saddest points of my internship. I was despondent and thought about resigning for some time. I decided to stay and complete my rotation on that service and put it behind me when I was finished. And that is what I did, I was busy in my third rotation when the novel coronavirus arrived in Peru, and all the medical students were sent back home. My internship was put on hold indefinitely. During the following weeks, I reflected on what had happened.
Neurodiversity is the variation and differences in neurological structure, viewing these differences as normal and natural rather than pathological. Several recognized types of neurodiversity exist, including autism, Asperger’s syndrome, dyslexia, dyscalculia, epilepsy, hyperlexia, dyspraxia, attention deficit and hyperactivity disorder, OCD, and Tourette syndrome.1 I was first diagnosed with depression in late 2018 but was later confirmed to have OCD. I remember asking twice if I had the disorder, not the personality. A person with OCPD (obsessive-compulsive personality disorder) has some rigid behaviors, but does not engage in the overwhelming need for repetition linked to OCD compulsions. OCD affects all aspects of life, making work, school, or healthy relationships impossible if untreated. In contrast, OCPD could relate to improved performance at work or school, but relationships with other people are not likely to suffer. The media’s depiction of people with OCD is overwhelmingly dramatic and miserable. I remembered searching on the internet to read about famous people with OCD. When I read about actor Leonardo DiCaprio’s OCD diagnosis, I admired him as a successful actor and environmental activist. At that time, I did not find anybody in health care who had it.
The lockdown and uncertainty about my future worsened my OCD symptoms. I decided to write about my feelings. I have previously written a little about my struggle with mental health for the American Society of Clinical Oncology.2 However, my story during the Medical Student Story Slam of the American College of Physicians3 was the first time I was open to the public with my OCD diagnosis and debilitating symptoms. I dreaded the day when the video was going to go live, but, once it did, I felt relieved. Everybody was very supportive. I cannot count how many direct messages I received on Twitter from people in health care with OCD. They were no longer alone because they could identify with my journey. Being open about my OCD diagnoses was my way to regain some power after being outed against my will. Not everybody has to be open with their diagnosis. However, I opened up after my terrible experience because I refused to be ashamed of my condition. I found a great community on social media and learned about neurodiversity. People with neurocognitive disabilities have talents, perspectives, and skills that can be distinctly beneficial in many work environments, including medicine. I am proud to represent and advocate for a more inclusive and neurodiverse medical force.