David Altshuler, M.S.
(305) 978-8917 | [email protected]

“More counseling needed on college campuses” proclaims a recent Time Magazine piece.  “Depression at record levels.” Academic pressure is cited as a cause of the overwhelming burden on scarce resources. 

A student is depicted. Her schedule includes premed courses, collegiate soccer, and a full social life. The article does not specifically mention the curriculum so I will note that in order to have a shot at a successful application to medical school, she must excel in calculus, physics, biology, chemistry, and organic chemistry. I am exhausted just writing down the course names. And did I mention that she needs two semesters of each? And that any grade other than an A in any of the classes does not necessarily preclude her from consideration, but it doesn’t do her any good either. Organic chemistry? What is that even about? Carbon? That any number of my relatives are indeed carbon-based life forms is probably not enough information to get me through the first semester, never mind the second. 
The kid is depressed because she is overwhelmed and overworked? Maybe. Here is a possible rival hypotheses: Maybe she just has an inflated sense of her abilities. Her parents have brutalized her with “you can do anything;” and “you’re the best.” Perhaps to the contrary, she can do ALMOST anything and is actually SECOND best. Maybe, for want of a more exact appraisal, she is a 93rd percentile kid. Successful medical school applicants may be 97th percentile kids. With her commitment to soccer, perhaps our sympathetic protagonist is motivated and able to study four hours a day. The kids who are a little bit smarter are studying five hours a day. Of course she needs counseling. I too am depressed just thinking about all that time spent studying organic chemistry. 
Having introduced myself into the previous paragraph, I will say something else about me: after winning the Boston Marathon, I would like to sit in a hot tub sipping designer lemonade discussing my upcoming Nobel Prize acceptance speech with Sophia Vergara. Watch this space for details of when those events come to pass.
Indeed, were this 61-year-old, punching, balding author to attempt to keep up with the leaders from Hopkinton, he would doubtless be unhappy—possibly even anxious and depressed—as his legs caught fire and his lungs exploded. No amount of “access [to] breathing exercises,” or “listen[ing] to a playlist designed to cheer [me] up” would make a positive impact as I was wheeled into an ambulance.
Not everyone gets to win the Boston Marathon. Not everyone gets to attend medical school. Parents make a tremendous mistake endlessly encouraging their children to accomplish that of which their children are just not capable. 
I see this paradigm repeatedly in my professional practice. “He is so smart,” parents lament. “He could do the work but he refuses or he’s depressed or he just needs more support.” No, actually he cannot. It is not the case that he can’t do the work because he’s depressed. The reality is that he’s depressed because he can’t do the work. 
No one is more in favor of therapeutic support than this author. But I have another suggestion. Lower your expectations. We need content nurses. We need happy physician’s assistants. We need self-actualized physical therapists. “Organic chemistry makes more history majors than it does doctors.” Good. There is a place for cheerful history majors also.
I hope the student mentioned in the article benefits from counseling. I wish there were services available for all students in need. But a meaningful step in helping her achieve a life with a healthy balance is to change her goals. This student could be a star in any number of other academic disciplines. By focusing only on medicine, she sets herself up for disappointment, anxiety, stress, and depression.
Picture of David


10 thoughts on “Time

  1. Jonathan Rose


    One of your best! I have seen this problem arise with the children of
    many friends. Great advice.



  2. David Lerman

    The cold hard truth at point blank range. Lovely. Timeless.
    Looking forward to the next publication, “Get the truth about your kid into yourself, Get yourself out of your kids way.”

  3. Nancy Vogt

    Dear David,
    The undergraduates in my classroom often blame the stressors for their stress, and they have NOT chosen demanding programs of study. They have not learned that it’s how they choose to react to stress that can lead to the now rampant anxiety and depression on college campuses. Ms. pre-med could well learn to make amends with another career direction, but learning how to deal with her own stress would be a big plus in her life.
    Thanks as always for a thought-provoking column.

  4. William Dickerman

    Yes. College attendance would not have to be so stressful if more emphasis were placed on finding the right place for each student. If parents, counselors, admissions officers, and students themselves would focus more on finding the right fit, mental health emergencies that come from too much stress could be significantly reduced. College can be a wonderful growing and learning experience, but not when a student is desperately trying to adapt to a place where he or she does not belong. There are other alternatives; and admissions offices should be helping guide students there, not just giving a “Yes, you made it,” or “No, you failed,” answer to applicants. I wish more people would listen to you, David.

  5. Jon Reider

    David, you may already be familiar with Malcolm Gladwell’s David and Goliath. In it, he devotes a whole chapter to Caroline Sacks, a science whiz kid from Bethesda, MD, who went to Brown to do pre-med and crashed, tried again, and still crashed. It’s not clear whether she could have learned of another path unless she crashed on this one first. Gladwell shrewdly speculates that if she had gone to the U. Of Maryland instead, the grind would not have been as rough, and she would be a doctor today.

  6. Paul Felt

    This resonates deeply with me.

    I wish I had read this when I was in college, and failing miserably in Organic Chemistry!

    The sooner we stop trying to live up to others’ expectations for us, and be happy doing what we do well, the better.

  7. Pepa

    I shared this post because i lover it. Too much pressure since very early in academics… All but a healthy balance.

  8. Bernie P.

    Good column David, but I wanted to say that I was a little put off by the way you rank this hypothetical premed student as a 93 percentile second-rater compared to her first rate peers who perform in the 97th percentile. I understand your point that students/children may suffer from their parents’ inflated expectations, which engenders disappointment in the child that often leads to depression and other problems. But I also see the implicit elitism of this blog that glorifies what some might see as elevating robotic regurgitation by students and viewing them as leaders and followers in a big race or marathon, rather than looking at other metrics of academic performance and success.

    You may remember one of the speakers at my dad’s memorial service last December, his colleague and former department chair George Alexandraxis, reading from a letter of recommendation that dad had written for a former engineering student in one of his intro physics classes to support his grad school application at MIT. The student may have been ranked third or even seventh in this course, but Arnie found other measures of intelligence and other personal assets that commended the student for a spot at MIT, and his letter helped open the door to admission. My dad was always willing to see students as more than just smart grinds who wrote the best exams. He looked for other values such as creativity, motivation, overcoming challenges, willingness to ask dumb questions, and he saw each student as a whole person and not just a test taker.

    As the inheritor of some of my dad’s academic genes, not including his math/science genes, I was never made to feel like a second-rater. In fact, when he wrote his parent’s letter of recommendation to my top college choice (Bennington), I remember him telling the admissions committee that he would love to have me as a student in his classes. I think he said this not because I would be his best student but because I had other intrinsic indicators of success that he valued, such as my curiosity and reading ability that encouraged me to explore physics and astrophysics without the math.

    I hope this comment is helpful to you and hope to see you soon!

    1. David Post author

      Yeah, I expressed myself imperfectly. You found (one of) the weaknesses in the essay. Believe it or not, I wrote then deleted sentences trying to address exactly that point. But the paragraph was already getting long and meandering as it was. So I left out an important part.

      I MEANT to also convey the absurdity of comparing two children based on any number of characteristics—aptitude, motivation, shoe size. That children cannot be RANKED is a familiar theme of mine. I did not make that clear at all in this piece.

      Nice memory of your dad too btw. (Bernie’s dad was a brilliant UM physics professor who spoke seven languages and published profusely.) I had the same experience with him. He NEVER made me feel stupid. Although he certainly had every right and opportunity to do so.:-) He was willing to converse with me on topics about which his knowledge was infinitely greater than mine. Good guy. He’ll be missed.

  9. James McGhee II, Alexander Montessori School

    Dear David:
    Thanks for another thought-provoking essay. I think that students who enter college typically have the ambition to finish in 4 years. However, alternate paths maybe appropriate for some students. I think that even in (or especially in) the most selective high schools, this possibility should be discussed.
    The analogy to the marathon is apt. Some runners will run/walk – but they finish. It just takes more time! Giving the “gift of time” may be more fair than saying: “You need to complete the race in X time … but based on current performance, you are only fit to run a marathon of 20 miles, on flat ground, no hills, with ideal temperatures.” Many students may have the resilience to complete the “full race” under rigorous conditions, with sufficient time allotted!
    A given 93rd percentile student MAY be able to attend Brown AND eventually attend Med School – but MAY need to take a reduced class load, per year, and maybe finish in 5 years instead of 4 … to devote sufficient energy to getting the best attainable results…. and “have a balanced life”.
    I understand (as a parent who put two offspring through college) that finances pay a big part of the decision making for many families, when it comes to how long a student will spend in school.
    However, when we pro-rate our college education over then number of years in our life … the investment in an additional year of undergraduate studies, to have fewer courses per semester, might be well worth it to a student. A student could achieve better results in each course, and have a more balanced life.
    Yes, his / her 4th year might not be his/her graduation year. There may be the “bittersweet” that friends are leaving and she/he has one more year. But if more students chose this option, it would be less of an issue … there would be more peers on the “5 year plan”, so some social/emotional connection would still exist in the 5th year.
    $70K x 4 yrs at “elite school” = $280K. Years from 18-68 = 50 yrs. Undergrad cost per yr = $5,600
    $70K x 5 yrs at “elite school” = $350K. Years from 18-68 = 50 yrs. Undergrad cost per yr = $7,000
    I understand that these are before grad school costs. Every family needs to decide what it can afford, and what is “worth it”. Is an additional $1,400 over 50 years, “worth it”, for a student to be happy and successful at an “elite” school?
    I hope Higher Education will become more flexible and innovative. We understand that IQ is composed of aspects such as Verbal and Processing Speed. Some students may have a much more average Processing Speed, but be capable, given time, of succeeding to meet VERY high standards of attainment. Counseling during High School, about various options, and colleges becoming more flexible in expectations about “finishing times” – making it a more acceptable option… could be a great development.
    Best wishes! James McGhee II

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