Conversations with Physicians: Sindhu Manava, M.D.

By: Saumya Vodapally

Who is your biggest inspiration?

I would say my paternal grandmother. Growing up I had always heard stories about how she worked as a woman back in the 1960’s having a full time job, cooking, cleaning and doing all the things to take care of four sons and a husband. Listening to that was an inspiration to me because I knew that someone could actually work that hard and make it work.

What was your driving force to choose medicine?

I always talk about this experience but when 9/11 happened I used to live in New Jersey. It was always on the TV and I was able to see it upclose in terms of how it affected our friend circle. During that time I saw how important all the EMS workers were; I would say it started from there and translated to me eventually pursuing medicine. There was also an influence from watching CNN, seeing Sanjay Gupta on TV, and recognizing “Oh, that’s an Indian person and he’s a neurosurgeon”.

How has your perspective of medicine altered from being a premed or high schooler to what it is now?

It’s almost a 180 degree change in perspective that hit me hard in the third year of medical school. Throughout college I thought of medicine as a way to help people, critically think, and become the person my patients trust the most. I later realized that it’s a lot of documentation, bureaucracy, and your time being occupied by things that are not directly related to patient care. It was one of the most demoralizing things but by that point, this is going to sound terrible, I had financially and mentally invested too much into it. I had too many loans and becoming a doctor had become a part of my identity.

How do you feel in terms of mental health support you received from your school?

On paper and outwardly those services were always available. During launch week, the first week of medical school, they talk the most about mental health services. However at the end of the day, the most support that I got within my medical school community was from my small groups of friends, not the school itself. Support from my family and being with people going through the same experiences as me, people to gripe with—that was what got me through.

What did you find is the biggest flaw in the mental health support provided by medical schools?

Rather than take a bunch of people who are under a ton of pressure, studying all the time, and add a bunch of busy work on top of it that could have easily been removed from the curriculum, give students a little bit of space to breathe. I think that would have done wonders for our mental health. Take away the required wellness walks and wellness sessions and just give us our space. The structure of med school itself includes unnecessary nuances that can worsen our mental health. Putting a bandaid on the issue after it happens is one thing but being preemptive is another thing.

Is there a specific instance or time period in medical school that mentally took the biggest toll on you?

Yeah, I would say third year was very isolating and demoralizing, specifically my internal medicine rotation because I always felt very behind. It was evident to my friends and family too. There was a lot of information, regurgitation, and endlessly talking about problems. And then it seemed like every Monday I was coming in and all the patients I had been following the previous week had died. It was very disheartening and made me very jaded. One patient would die but then another would come in; I felt like a hamster on a wheel during that rotation.

How do you cope with patient mortality?

The weird thing in residency is that death becomes nothing, almost like going to work and getting a coffee. When someone dies it becomes very clerical; there’s disease paperwork, preparing the death certificate, calling the funeral home, all these things. One of the patients on my floor died at around 6 pm the other day and my first thought was “Now I’m going to go home late.” I’ve seen that it almost becomes a defense mechanism to talk about it like it’s nothing. It’s just a very weird and warped way of thinking and I really do feel that it takes away some part of your humanity. But that’s part of the job.

Is there one specific experience you would like to share?

One of my patients was extremely sick and ultimately died due to complications from his illnesses. He was put out of his misery but after his passing I would see his face in my sleep, cry out of nowhere, constantly read his chart, and read his obituary; it was very unhealthy. My husband was the first person to notice and he really helped me. My chief residents pulled me aside, knowing that something was wrong. They had to screen me for depression, and I probably qualified in the moment. When I’m called to a patient’s bedside, their heartbeat is 140, they’re breathing really fast, and they’re about to die. I’m looking into their eyes and thinking “these are their last few moments of life that I’m watching”. And there’s just no time to talk about it past that.

What is a truth about this career path you have realized and would want to share?

By the time I can wake up on a Monday and not have to go into work until 8am, I will be around 32 years old, possibly very exhausted having lost my entire 20’s to this training. If I had a job that was 9-5, where I could see my family more often than once every 5 months, see my husband regularly, and see my friends, I probably would have been a happier person. This doesn’t mean that I don’t love what I’m doing right now because I do. I believe that this is truly where I belong. It’s just the added nuances that come along with this field, which can make you question it.

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Dr. Sindhu Manava is currently a first year general surgery intern in Grand Rapids, MI. She grew up in NJ and went to college and medical school at the University of Connecticut. Dr. Manava trained in Indian classical vocals throughout her childhood and met her husband on her a cappella team in college. Her favorite things to do are sleep in, visit national parks, enjoy her husband’s cooking, and watch documentaries. In her residency and throughout her future she hopes to pursue her interest in global surgery.

Saumya Vodapally is currently a junior pre-med undergraduate student at the University of Connecticut double majoring in Molecular and Cellular Biology and Women’s, Gender, and Sexuality Studies. In her free time she loves reading, playing with her dog, spending time with family, and working out. As someone who is passionate about mental health, she was able to converse with Dr. Sindhu Manava to learn about her medical journey.