Health & Wellness

Reflections on Failure … and What to Do About It

“Failure” feels like a dirty word, something no student dares to mention for fear of jinxing themselves. It’s like the boogeyman, looming in the shadows, preying on the fear thatdespite all our effort, time and moneyit was all for nothing … and that light at the end of the tunnel dims. No one speaks of failure for fear of summoning it, yet it creeps up on us at the worst possible time and punches us while we are down. A quiz grade here, a skills test there, an exam that was SO CLOSE to passing, but didn’t quite make itfeeling like no matter what you do, you will never improve, that you are doomed to never be successful. 

These feelings are entirely normal, especially for students in high-intensity academic environments where failure can have serious financial consequences beyond the emotional toll. Optometry school is already stressful enough as it is, and the entirely legitimate fear of failure simply adds to it. Because we can’t wave our hands and magically hypnotize all of our professors into giving us As, the question then becomes: What can we do about it? 

It’s helpful to think of failure as a disease state. It does, after all, induce all the hallmark signs and symptoms of anxiety and depression, potential causing headaches, nausea, rapid breathing, acid reflux, body aches, insomnia, fatigue and a weakened immune system (thanks, Cortisol, for the memories!). It also can frighten classmates into steering clear of the affected individual, as if it were somehow contagious (news flash: it isn’t). And because we’re thinking of failure as a disease state, that means we’re going to need:  

  • Adifferential diagnosis – finding the root cause(s).  
  • Atreatment plan – a step-by-step outline of how to recover.  
  • Prophylaxis –a way to prevent it from happening in the future.  

 

Okay, so you’ve failed your first quiz, exam, skills test or some other official assessment. Take your time to experience those emotions (as there will be emotions), and then your first step is to contact your professor, sooner rather than later. Your job when meeting with your professor is to go over all the concepts covered in that assessment and find out WHAT HAPPENED. If you misunderstood the information, your next step will be to arrange for tutoring or additional office hours to supplement your time in class. Do not hesitate with this and make sure to go over concepts every week leading up to the next assessment. If you are having difficulty memorizing the sheer volume of material, then you will need a different kind of help; you will need to work with your professor to help orient yourself around the material and get a good outline in your brain established that you can then build on with details (you also may  need assistance developing study skills; if so, reaching out to your school’s academic support office will be your next step). If you understand all the material and are able to recall it in front of the teacher but have difficulty with the format of exams and showing what you know on a highstakes exam, your next step will be working with your professor and your school’s academic support office on testtaking strategies, potentially even working with your school’s mental health services personnel on dealing with anxiety and blanking within the testing environment.  

 In any and all of these scenarios, it is CRITICAL to get this taken care of AS SOON AS POSSIBLE. It is ABSOLUTELY possible to recover from a stumble (i.e., a quiz or a single exam) without it affecting your grades too much, but if it builds you can risk failing a course, which can be devastating depending on the policies of your school. This is where the prophylaxis comes in. Obviously, no one is planning to fail, but when it comes to optometry school, where the stakes are understandably high, it is important to plan for the worst and hope for the best. If you are afraid of failure, for any reason, at any time, make an appointment with a member of your school’s administration and talk to them about your fear and your reason for fearing. Listen to their advice, as they will point you in the right directionthey don’t want you to fail any more than you want toThey also can tell you what your school’s policies are for remediation and for taking a leave of absence if one is needed. Because every case is different, it is critically important to get this personalized assessment and to build a game plan that will help you succeed in your program.  

 Please note that in this entire essay, we have not yet discussed how to handle the emotional toll that comes with failure or the fear of failure. This is because the means of achieving mental health is different for each person and what works for one individual may or may not work for another. Whatever it is that you need to do to pull yourself together, then that is what you need to balance with your studies. My only piece of advice in this arena is more of a request: please, please, PLEASE do NOT hide your failure. Yes, it is embarrassing, and no, you do not need to advertise it, but recognize that when an academic community functions within a culture of hiding failure, it makes it so much more difficult to learn from it and to recover from itInstead, show the world your strength and resilience, for your failure is not what defines youyou are defined by how you choose to overcome it.  

Health & Wellness

Mind, Body, Soul

I think it’s fair to say 2020 has been a tough year that has upended our lives in many different ways. Getting through a global pandemic, along with the added pressure of optometry school, challenged my mental and physical health in ways they’ve never been before.  

As someone who truly values routine in my life, I found myself struggling when this structure was no longer there. The turning point for me was when I stopped resisting all these changes and accepted it. This acceptance shifted my mentality from victimhood to a growth mindset which then allowed me to adapt to the changing circumstances. 

Now whether you’ve had a similar experience to me this past year or maybe you’re battling your own respective challenges, I would love to share some tips that helped prosper my health and wellness during these turbulent times. My approaches focused on nourishing the three domains of my wellbeing that I felt were most important: mind, body and soul.  

Mind 

As students in optometry school, I feel like our mind and mental capacity are challenged on the daily. Or maybe it challenges how much information we can shove in our head four hours before an exam. Nonetheless, our minds are consistently engaged in this aspect. 

As important as it is to challenge our mind, I think it’s just as important to give it the rest it needs. Prioritizing my sleep has been one of my goals this past year and it has had profound impact on my mental health. If I have an exam the next day, I try my best to study all the material before a reasonable time so that I can get at least 7-8 hours of sleep. This shift was made possible after I self-acknowledged that my well-being is more important to me than getting a perfect score on a test. 

Another realm of our minds is our thought processes. This past year I realized the importance of having these thought processes challenged. Oftentimes, our views on certain topics and the way we think about certain things can be linear and based on the way we were raised along with our individual experiences. Having these thoughts challenged can possibly widen our perspective and provide a deeper sense of compassion. I believe developing compassion is one of the most empowering characteristics to possess as health care providers. 

Body 

As up and coming health care professionals, I believe the importance of staying active and getting a daily dose of physical activity has been stressed more than enough. I can attest to the countless benefits I’ve experienced in my everyday life due to this practice.  

Prior to lockdown, my routine consisted of going to our school gym first thing in the morning. However, once lockdown started, I was left in my bedroom with a yoga mat and some make-shift dumbbells that were less than ideal. My motivation to get that daily exercise became extremely diminished, but I knew it had to get done. That 45 minutes of physical activity resulted in a full day of increased energy and better mood. I also came to the realization that starting my day off with exercise made the other tasks I had to complete in the day much more attainable. 

If you’ve already established this habit in your life, I’m sure you’ve also experienced these wide range of benefits. If you’re someone who‘s been looking for some extra motivation to get started, I hope reading this has been able to give you some of that. You should get started with an activity you enjoy (biking or yoga) at a time interval that’s comfortable and slowly start working your way up. 

Soul 

The soul is the core of our being. The times where I feel the most in tune with it is when I’m not thinking about anything and just focused on the moment at hand. As trite as it may sound, I feel the most connected when I’m walking through the forest. There’s something about the organized chaos that grounds me and engages all my senses in a way that nothing else can. I have tried to make this a habit once a week and I’ve noticed that it provides me with this sense of clarity and awakening that coffee can’t achieve.  

In today’s world, it can get hard to have some time to yourself where you’re not bombarded with notifications and the upsetting news around the world. Therefore, actively seeking those moments where you don’t have to engage in anything except yourself can be very powerful. I live close to a forest so those walks are what bring me peace, but your practice can be individual to you. Whether it’s meditation, yoga or just sitting on grass and watching the sky; I think you’ll find profound benefits in slowing everything down in a world that’s constantly moving. 

I personally don’t have it all figured out, but these are just some of the things that have helped me this past year. I’m sure these are things you already know, but sometimes it takes reading it at the right time to actually implement it. As we move into 2021, let’s prioritize our health and wellbeing and start to welcome change.

Health & Wellness

Building Community Care as Mental Health Support in Optometry School

My Experience with Mental Health
During my first year of optometry school, I had a difficult transition that eventually led to challenges academically. I wish I could tell a straightforward story of how I didn’t know how to properly study or balance my academic life, and that working harder led to my success–but my story, as with any person’s story, is much more nuanced than that. Living with mental illness, my story often gets reduced by the common discourse around mental health that is shaped by the medical model of mental health and disability​. The medical model defines a person by their impairments or differences, and focuses on how to fix or change these differences by medical or other treatments, with the goal of eventually curing a person so they can be normalized and reintegrated into society. Even language around mental health often uses stigmatizing words such as “suffering from” or “struggling with” a certain mental illness, and that the individual must be responsible for fixing what is wrong with them in order to be productive, functioning, and successful. Alternatively, there is the social model of mental health and disability. The social model focuses on the way society is organized and what barriers and opportunities are available for a person. It is not about what is wrong with a person, but rather what can be changed about the system or environment a person is in. Suddenly I realized that my difficult transition into optometry school wasn’t because of my mental illness–it was because accessing resources and support systems for me to thrive with my mental illness were particularly challenging in respect to my unique circumstances and marginalization of my identities. With this understanding of the social model of mental health, I became determined to share my experiences and work with others to shift the mental health discourse within my own community.
Mental Health During 2020
Fast forward two years to today, conversation about the increase in mental illness during the COVID-19 pandemic has become widespread. In a September 2020 ​article from Science​,40% of surveyed graduate students in STEM had reported symptoms of anxiety and depression, increasing nearly 20 percentage points from 2019. When considering our optometric student community, I can only imagine how this has been a particularly difficult year,especially for our first year students or any students experiencing a drastic transition. But let’s remember to be specific about what’s causing this current increase in mental illness. This year’s COVID-19 pandemic and protests for racial justice brought us a heightened understanding of inequity and injustice–so when we speak about how COVID-19 has increased mental illness, we must speak specifically about the social and economic conditions that impact mental illness because doing so enables us to find tangible ways to shift our focus from awareness to action.
Student Action
Last year, a small group of us students formed a Wellness Committee to augment the existing mental health resources at our school and highlight events throughout the city that address mental health and well being. But this year, we recognized awareness and self-care
wasn’t enough. As diversity and inclusion efforts at colleges of optometry have been working to address systemic racism and the environments of our schools, we saw that ableism and mental health were often addressed separately or left out of this picture. Shining a light on privilege causes us to no longer assume that everyone can access the same routes of healing or have universally successful experiences with mainstream mental health care. We decided to form the first optometry school chapter of the national organization ​Project LETS​ (Let’s Erase the Stigma); a peer-led grassroots organization that centers the voices of people with lived-experience of trauma, mental illness, chronic illness, disability, and neurodivergence. Our goal became that of building: community care, peer support collectives, inter-sectional education,and our capacity for responding to and transforming harm.
What is community care?
Community care is how we will be able to begin addressing issues of oppression such as racism, xenophobia, Anti-semitism, Islamophobia, homophobia, transphobia, ableism, and soon​. ​It is the ways in which we facilitate community interactions, conversations, and structures of support. It is rooted in how we hold empathy within groups and between groups, such as that of students, faculty, staff, and patients. It is our understanding that there are factors affecting all of us that self-care and individual pursuits of healing alone cannot achieve. When it comes to trauma and oppression of marginalized peoples and identities, we need relational healing.
What are different barriers to mental health support?
We cannot assume everyone has supportive friends and family, are able to talk to someone, has access to therapy or medication, has insurance, is able to advocate for themselves, is able to safely share their story, can access certain mental health language or information, or is empowered by the same resources. For example, not all students can feel safe sharing their experiences to individuals of greater hierarchical power such as faculty or administrators. Not all people find hotlines or textlines helpful during times of crisis, and could potentially be further harmed if police or emergency responders are called while in crisis. Our widespread discourse can also be a barrier to mental health support. As a community, challenging the medical model of mental health and disability, and opening up to other models could be a helpful tool for some to contextualize and navigate healing in a way that won’t further their feelings of being isolated and pathologized due to their experience. In doing so, we also can shift away from thinking happiness means being free or cured of mental illness. We can begin to view healing as a non-linear journey that is about the process more than it is about the end goal. Considering the ​intersections​ of a person’s identities, we must also recognize the barriers that exist due to systemic and societal marginalization and oppression. These are factors we don’t always consider when we are thinking about a student’s academic success.
What can peer support in optometry school look like?
Having structures for peer support is important because it breaks down some of the barriers listed above for accessing mental health resources. Peers can share their similar experiences and help their peers find autonomy and hope. For us, forming a chapter of Project LETS enables students with lived experience to apply to become Peer Mental Health Advocates (PMHAs) and be provided training by the national organization. This is a ​16-hour training that isdeveloped by peers with lived experience, and informed by Intentional Peer Support (IPS) and Certified Peer Recovery Specialist (CPRS) curricula. PMHAs engage with a variety of topics during training including: principles of Disability Justice, the history of psychiatry,empathetic listening skills, crisis response skills, cultural competency in peer support,building crisis and safety plans, etc. Our hope in the future is to have faculty and staff become PMHAs for each other as well.
Why is community care important for the broader optometric community?
When we talk about community care, we are extending our responsibility of addressing mental health, ableism, marginalization, and harm to the greater community and society rather than the individual. With community care, we are viewing mental health through a disability justice lens. Our goal in optometry is to help people see, but through a disability justice lens, our goal is to prevent or reduce the impacts of visual disability and make environments more accessible. For example, it could even be as simple as ensuring a person with myopia has eyeglasses so they can learn at school–but through the social model of disability we know that accessing eyeglasses isn’t so simple for everyone. It is through these frameworks that a parallel between mental health and optometry exists, and we become better able to address the barriers for people with mental illness, and the barriers for our optometric patient community. Without recognizing this, the ableism that we internalize as students later becomes the ableism we practice with as optometrists.
Advice Column / Health & Wellness

Make Mental Health A Priority

COVID, elections, zoom, family, friends, sanity. The list goes on and on. It can be difficult to step out of your own bubble to realize everyone around you is going through their own version of the same thing. We worry about our loved ones’ health and safety; we worry about the state of our nation; we worry about keeping up with countless online platforms just to stay on track with school, and all while maintaining our personal and romantic relationships.  

 

It can become very easy to feel desensitized by all the negativity we are bombarded with on the internet and it has become almost normal to expect the worst in the year 2020. We’ve all heard the jokes and the seen the memes. It feels almost unnatural to continue regularly scheduled curriculum while the world around us seems to be in a state of instability. Add the presidential election to the mix, and you have yourself the perfect recipe for anxiety. Not only is the abrupt transition having an impact on our learning, but also on our mental health.  

 

I challenge you to take charge of your mental health and reach out to various resources available to you. Many universities offer counseling/therapy free of charge to their students and you would be surprised how beneficial it is to talk about your personal experience with someone outside of your close circle. Personally, I had never participated in counseling sessions until recently, but it took a small weight off my shoulders and that made all the difference. Normalize saying no to others once in a while and take time for yourself to catch a breath. I know a lot of us are overachievers and want to do it all, both in our personal and academic lives, but it is important to take a step back and remind yourself how far you’ve come and to put yourself first. As someone who’s always had trouble reaching out for help, I can understand the hesitation.  

 

The first few months into the pandemic it seemed easier to stay productive with projects, trying new recipes, learning TikTok dances and even catching up on schoolwork. Now that we are more than half a year into the new normal, motivation can be harder to come by. For those 1st years who are beginning their journey in optometry virtually, for those 2nd years that are struggling to keep your clinical skills up to date with limited in person practice, for those 3rd years that are struggling to study for boards and keep up in clinic, and for those 4th years that are trying to learn as much as they can on rotations before setting forth onto the real world, remember that we are all doing the best we can and that is all anyone can ask of you.  

Health & Wellness

Optometry: Opening The Door To Disease Prevention

It is well known that chronic disease is a driving force for doctor visits today and comprises a large component of health care expenses. However, it has been found that a strong link exists between preventing chronic illness and proper education on smoking cessation, alcohol consumption, physical activity, and nutrition.

Overall wellness involves not just the physical aspects of one’s health, but the mental and social as well.The concept of an integrated health care team is becoming even more essential in the management of patient care.  

As optometrists-in-training, we have the knowledge to educate and guide our patients towards the right information and resources needed to achieve optimum wellness. Optometry in particular is especially unique in that the doctor-patient relationship created from examining the eyes sets up an opportunity to offer preventative health advice. Patient education on nutrition is just one important component in the multimodal approach to the management and prevention of chronic health problems. However, what healthful information we tell our patients is just as important as how we present it to them. In this article, we’ll talk about why optometrists are in a critical position to influence disease prevention, how to open up conversation about health to our patients, and what pieces of nutritional advice we can provide during patient education.  

In optometry school, we are taught to gather information along every step of the comprehensive exam: beginning with the key elements of a thorough patient history and ending with a complete vascular and neurologic assessment of the back of the eye. We get to know our patients’ personalities and lifestyles by asking targeted questions and using careful listening to deeply understand the entirety of their complaint and condition. By the end of the exam, we have a wholistic picture of our patients’ mental and physical wellbeing. This unique perspective places optometrists in a critical position to be able to impact the health of our patients. However, the manner in which we communicate with our patients is a crucial step in initiating change in their lives.  

Patients with chronic health conditions may feel overwhelmed and rarely motivated to act when given a laundry list of health checks they must meet.

Adopting a patient-centered approach by showing empathy, carrying open, non-judgmental conversation, and seeing the patient’s perspective is important in order to leave them feeling empowered to change.

Motivational Interviewing (MI) techniques have been found to be an effective mode of communicating to increase intrinsic motivation, particularly in diabetics. Below is a list of example questions, some of which have been adopted by the MI technique, that can be used to spark open conversation about health and establish rapport during patient education, a concept shown to leave patients feeling more confident about taking charge of their health.  

  • “With your permission, I’d like to propose a plan…” or “If you don’t mind, may I share a bit of information with you…”1  
  • Replace “I think…” or “You should…” with “Perhaps you could start with…” or “One option you may consider…”1 
  • “Tell me what you prepare for breakfast in the morning…” 
  • Patients in the past have found that…”1 

With the immense amount of health literature that we have access to today, it can be difficult to narrow down the most important take-home message regarding nutrition and health. Vitamins, minerals, and antioxidants play a critical role at the micronutrient level at impacting our metabolism, microbiome, and cognitive function as well as preventing eye diseases like age-related macular degeneration and diabetic retinopathy. While patients may have a generalized understanding that proper nutrition can affect their physical health and weight, not many are aware of the nutrients essential to eye health. Patients often respond the best when given a single piece of advice, and are surprised to hear that such small changes can make a large difference in their overall health.  Included below is a list of important elements in nutrition and eye health to steer patients towards healthier habits. 

  • Lutein & zeaxanthin. Xanthophylls are one of the two categories of carotenoids, antioxidants that play a role in protecting the health of the macula, ocular surface disease, cognitive function, and skin health. Add 1 cup steamed or 2 cups raw spinach to your meal each day. This could be in the form of a smoothie, a salad, or sautéed into your dinner. Sidekicks are kale, collard greens, swiss chard, arugula, and bok choy.2  
  • Carotenes. The second of two categories of carotenoids. Color your plate with red and yellow peppers, sweet potatoes, squash, cantaloupe, apricots, peas, and broccoli.2  
  • Vitamin C is a water soluble, potent antioxidant that plays a role in immune function and wound healing, among others. The most abundant natural sources include guavas, kiwis, and bell peppers, though a dissolvable supplement in a glass of water may be necessary in order to reach adequate levels.  
  • Vitamin D is a prohormone that has a supportive role against autoimmune disease, fractures and falls, depression, heart disease, influenza, and type 2 diabetes.2 For fair skinned individuals, spending a few minutes outside without sunscreen, or for darker pigmented skin, up to 15 minutes, would be enough.  
  • Healthy fats, specifically polyunsaturated Omega-3 fatty acids (EPA, DHA, ALA), have been found to support ocular surface disease, fight inflammation, improve cognitive function, and contribute to hormone production. One handful of walnuts, five times per week, or incorporating wild salmon, Alaskan halibut, or canned, chunk, light tuna (1,000-2,000mg/day) is recommended.2  
  • Absorption of vitamins with healthy fats. In order for proper absorption of vitamins, supplements or foods should be taken with or cooked in healthy fats including avocado, nut butters, and olive oil.  

While these are just a few aspects of health that we encounter during patient care, the optometric exam opens the door to caring for so many other areas of overall wellbeing. As largely a medical profession, we can positively impact our patients’ lives beyond their eyesight and significantly contribute to disease prevention in our community today.  

  1. Welch, G., Rose, G., et al. (2006). Diabetes Spectrum. Motivational Interviewing and Diabetes: What Is It, How Is It Used, and Does It Work? 19(1). 6-8. 
  2. Richer, S., Poteet, J., Summerton, S, et al. (2018). Review of Optometry. Wellness Essential for Clinical Practice. 1(1), 6-17.   
Health & Wellness

6 Life Hacks From A Fourth-year Student To Enjoy Your Uni Years

Have you ever met someone who always has time, never denies an invitation and is always up for trying something fun or doing something spontaneous? I have a feeling these people are getting more and more rare. I find it so sad that most people (including myself) are stuck in their strict schedule, thinking it’s just a phase. We think it’s always going to be better/easier/quieter later, but of course that is never the case. Life never slows down, new challenges are always ahead and we always postpone our happiness. For the most part, I think us students are particularly prone to thinking that way. You’ve probably heard many of your friends say that once they graduate, life is going to be greater and easier, or maybe you’ve even said so yourself... There’s nothing wrong with being excited about the future and dreaming ahead, but what I do think is wrongful is thinking that right now is not a perfectly enjoyable moment to live as well. Don’t get me wrong, studies are hard. I mean they are mucho hard when you’ve already downed your third coffee of the day and you still have 1,000 slides to study for your exam the next day. The thing is, we have to take charge of our own happiness and find ways to enjoy the present. Here’s my take on this very important issue: 

 

First of all, don’t wait to until you’re exhausted to take a break! 

If you plan your breaks, they’re going to be way more satisfying and soothing. Procrastination is always tempting, but have you ever tried premeditated procrastination? It’s a whole other game, I swear! The real satisfaction and benefits of taking some time off comes when your rest is planned. 

 

Say yes to spontaneity sometimes! 

I know I just told you to plan your breaks, but every good advice has a bit of contradictionWith everything that is planned nowadays, up to appointments to see your friends, it is good to keep our minds sharp and our adventurousness on our toes with unexpected activities. I suggest you try to do something spontaneous at least once a week. That way you’re allowing yourself to feel the liberty and flexibility of not having to follow a precise plan. 

 

Mindfulness and meditation 

That one is already understood. I won’t elaborate much because you’ve probably heard a lot about it, but just know that if you’re dealing with anxiety, the art of living in the present can really become your best friend. 

 

Journaling about what you’re thankful for 

I have yet to try this one, but apparently taking five minutes every morning to write down three things you are thankful for will trick your mind into thinking that you are the luckiest person alive and therefore make you happier in general. It won’t keep bad days from happening, but it will make you more positive in the long run. Looks promising! 

 

Don’t neglect personal growth  

We all have some personal stuff we want to work on, but we often don’t take the appropriate time to do it. Whether you want to work on your self-confidence or improve your communication skills, try to work on these goals on a weekly basis. Even though personal growth takes time and effort, it is always an excellent investment of time. Investing in yourself should never be procrastinated. 

 

Notice, notice, notice! 

Make sure you are aware when of when you’re having a good time! Take two seconds to fully realize that you are living your best life RIGHT NOW! If you do this often, you’re going to trick your mind into thinking you’re the happiest person ever.  

 

That’s all my advice for now. I hope you find a technique or two that works for you. I am not a professional in the wellness field, but I am a student with the absolute certainty that every step in life is neither better nor worse than the next, it is simply meant to be enjoyed as much as we can.  

 

From an already nostalgic fourth year student at University of Montreal, 

 Catherine Poitras