In summer 2021, as Simone Biles bid farewell to competing alongside her peers in the team finals at the Tokyo Olympics, I found myself in a similar position, saying goodbye to my fellow medical students as they continued their education without me. Both Biles and I faced the daunting decision to take a leave of absence because our mental health had impacted our performance — Biles in gymnastics and myself in medical school. This decision was not made lightly, and the stigma we faced from each of our communities was immense.
We live in a world where taking a break is often equated with quitting, especially for Black and Brown women in the U.S. Both Biles (Black) and I (Brown), were labeled as “quitters” when we prioritized our mental health over our professional aspirations. The shame is compounded by the pressure to push through, despite the clear danger it poses to our well-being. For Biles, it was the risk of physical injury in her sport; for me, it was the risk of severely worsening mental health.
I originally took my leave of absence because I was struggling to pass the practice exams during the dedicated Step 1 study period at the end of my second year of medical school. However, instead of first focusing on improving my mental health, I adamantly pushed myself to keep studying. This resulted in a failure on my Step 1 exam, and further delayed my return to medical school.
As Biles explains in her Netflix documentary Simon Biles Rising, she similarly pushed herself in the Tokyo Olympics, even after noticing that she was reaching her emotional limit. As a result, she ended up faltering on a vault routine and realized she could not complete the Olympics at her very best. In turn, she sat out from the rest of the competition; just as I sat out from medical school.
Spectators around the world were in shock at her decision, in part because she didn’t have a physical injury. This would have “justified” sitting out.
But in contrast to physical injuries, mental health struggles are often invisible, making them harder for others to understand and accept. Biles’ mental blocks and overthinking during her gymnastics routines mirrored my own struggles during standardized board exams. It became evident that pushing through these blocks was not only unproductive, but also threatened our well-being. The decision to step back is often not about quitting, but about individual survival and preventing a complete mental breakdown.
The stigma around mental health is pervasive in both gymnastics and medicine. There is an unspoken expectation to endure grueling schedules and intense pressure without complaint. The pandemic only exacerbated these conditions, highlighting the unrealistic demands placed on both athletes and medical professionals. Betty Okino, a former Olympic gymnast, spoke in the documentary about how the system weaponizes the term “resilient,” reducing individuals to mere performers of strength rather than acknowledging their humanity. This is an unfortunate reality that medical students and resident physicians also face while pushing through 24-hour shifts and 80-hour work weeks.
During my leave, I felt out of control, much like Biles described feeling like a prisoner in her own mind and body. We both took time to heal from past traumas, which often resurface during periods of high stress. As a psychiatry resident and fellow trauma survivor, I understand how untreated trauma can manifest in both mental and physical health issues. Healing is a slow, deliberate process that cannot be rushed, and it’s crucial to address this trauma during any leave of absence.
Biles’ journey back to gymnastics, getting “back to the basics,” and rebuilding her confidence, mirrored my own return to studying for Step 1 after the failure my first time. I had to review content from my first 2 years, taking time to rebuild my foundation. Both of us found strength in our supportive communities — Biles’ teammates, and for me, a group of fellow medical students. We also leaned on our mental health therapists and our boyfriends or husbands, who saw us through our darkest days.
People are often more understanding of visible injuries than of mental health issues. However, both can be equally debilitating. Biles’ courage to prioritize her mental health on a global stage inspired me during my own leave of absence. Biles’ return to the Olympics this year and my return to medical school for the third year — culminating in my graduation and residency — are testaments to our true resilience and determination.
Professional sports players and doctors are often seen as superheroes, but we are human. In the documentary, Biles spoke about being the painter of her own story; similarly, I believe everyone in medicine has a unique journey that they create. Our experiences show that taking a step back is sometimes necessary to move forward.
To anyone facing similar struggles, know that taking time away from your dreams for your mental health is not a sign of weakness. It is an act of courage. Biles and I are not quitters. We are survivors, and our leaves of absence were just chapters in our life stories.
Stephanie Moss, MD, is a first-year psychiatry resident physician at Rosalind Franklin University, dedicated to addressing mental health disparities and advocating for individuals with marginalized identities. Moss, an endometriosis and mental health warrior, hosts the podcast Life as a Patient-Doctor, discussing the humanity in medicine.
Please enable JavaScript to view the