The Tribune

By Dr Kenneth D Kemp

MY earliest tangible moment of self-reflection occurred when I graduated high school. It was the first time I’d ever looked back on my life and contemplated my future; seriously contemplated that is. Before that, there were lots of times when I contemplated a piece of that future, like what the next Saturday night would hold or how many more weeks I had to wait to get my driver’s license. But nothing compared to ending the longest chapter of my life to date, the school years before I would have to leave home and all the comfort and familiarity it represented.

There was a certain level of immutable excitement handcuffed to the fear of change. I knew I wanted to study abroad and become a doctor but for a short while I had a dormant fear that I might not have what it took to accomplish that goal. I was also unapologetically introverted and loathed the idea of having to make new friends. The reality is that over the years, I’ve come to appreciate that moving outside your comfort zone begets growth and builds character.

Still, I remember clearly the fear and the stress it induced. So, with several of my patients expressing similar fears in recent weeks as June graduations approach, I wanted to share their thoughts and feelings with you for several reasons. First, to let them know it is not just their generation. Stress caused by fear of change is as old as time itself. Secondly, to emphasise that by letting go of the fear, the stress vanishes and change can bring out strengths in them that they never even knew they had. Thirdly, stress can cause a medical condition known as urticaria. It is nothing to ignore despite others telling you, “Don’t worry, it’s just stress, it will go away.”

Despite the age difference between my patients and myself, it appears that many of those same feelings I experienced years ago are still in play, festering unmitigated by time. Where the differences materialize, however, is the amount of stress they endure throughout their final exam period and college application process and how much they are deleteriously affected by it. Reasons behind the increase in scholastic pressure are unknown to me but two patients, that I know of, took a gap year to either work or travel before making the transition to college life.

At this point, I’d be remiss without mentioning that many people graduate from high school and go into the workforce immediately without a college degree and become quite successful. But for those who matriculate beyond the secondary level, stressed by applications and dreaded national exams, they soon learn that further challenges loom ahead.

My patient, hereafter referred to as Luke, went to a public school from grade one to grade nine. During such time, he was exposed to gang violence repeatedly and on more than one occasion had a knife pulled on him by delinquent students hoping to confiscate his school bag, watch and footwear. In each instance, Luke successfully defended himself and by grade nine, he’d worked hard enough to earn a scholarship to a private school locally. There, he no longer had to endure school violence, but he quickly became exposed to drugs, teenage rebellion and multiple classmates diagnosed with anxiety and clinical depression.

With a strong moral character and a loving, supportive mother, Luke not only transitioned quickly but also excelled in his new environment. After graduating at the top of his class, Luke went on to study at an engineering university in the US. He admits that during those first few years the workload was so intense that he broke out in hives so extreme it covered his entire body. A visit to the on-campus doctor confirmed that he was suffering from chronic urticaria induced by psychological stress and anxiety, which is a condition that he’d never grappled with before. Already accustomed to an intense workload, and being the first person in his immediate family to attend college, his stress level hinged on his fear of failure and having to return home without a degree in hand.

The human body responds to stress by creating an inflammatory response as the nervous system is activated and the delicate hormonal balance is altered. This then possibly contributes to the onset of urticaria in some patients. A direct correlation between the two however remains unclear and requires further investigation. But, beyond the literature, it’s happening with such frequency in college students that treatment recommendations have successfully included advising students on how best to properly manage their personal and scholastic stress levels.

For the wider population, extending beyond college students, this advice has far-reaching benefits considering that in adults, stress may manifest as chronic high blood pressure further exacerbated by insomnia, excessive alcohol consumption, drug abuse and poor dietary habits. That winding road precipitously leads to Diabetes, stroke and the spread of cancer cells throughout the body. These are all primary causes of death in the Bahamian population undergirding the need for locals in all age groups to manage their stress levels more efficiently.

We have sociology and religious studies classes, students study math, science, history and geography, some schools even offer foreign language, computer and art but at no point are kids ever taught the importance of anger management, balance and coping mechanisms in the classroom setting. If they are, it’s no more than a passing topic sandwiched between arguably less life-pertinent topics. Dr. Carlyne Smith-McKenzie, a former National PAHO consultant, project coordinator for Red Cross and executive director of The Bahamas AIDS Foundation has long advocated for more emphasis in the school curriculum on identifying stressors and teaching students how to effectively use coping strategies.

I recently attended a preparatory school graduation where parents and loved ones came out to support graduates with customised T-shirts, flowers and balloons, clapping, screaming loudly and shaking cowbells to show their support. It takes a village to support one child and I believe a lot of the jubilation centres around understanding the countless sleepless nights that led to this moment. Beyond assisting with homework and class projects and participating in school raffles and plays, parents are relegated to taxi drivers as they commit to frequent and exhaustive car commutes to and from extracurricular activities and sporting events. Graduation is as much their victory as it is the students.

Luke wants readers to know that hard work pays off and after graduation, a winding road lies ahead. He maintains that if you stay the course and successfully balance the stress of the work with gratifying life experiences, nothing can stop you from accomplishing your goals. The sacrifices you make in your formative years yield countless dividends for you and your family and despite all the hardships he’s endured along the way, Luke says he wouldn’t change a thing.

In life, how we respond and adapt to challenges best determines our success and potential life expectancy. Arming recent graduates with the necessary tools to potentiate their confidence and attenuate stress precursors should accordingly be prioritized by educators and parents alike for the continued preservation of their health and well-being. In the long run, it can be a lot easier to get over a cold or virus than stress. We just never see it that way or talk about stress as something perhaps it’s time we did.

This is The KDK Report.

• Nicknamed ‘The Prince of Podiatry’, Dr Kenneth D Kemp is the founder and medical director of Bahamas Foot and Ankle located in Caves Village, Western New Providence. He served as the deputy chairman for the Health Council for five years and he currently sits on the board of directors for the Princess Margaret Hospital Foundation in his role as co-vice-chairman.