When You Forgot to Eat, Sleep, and Breathe—but You Remembered the Krebs Cycle

There you are, standing somewhere between the nurse's station and the OR, knees weak, brain fog thicker than propofol, and the only thing louder than your rumbling stomach is the echo of your own internal monologue reminding you: “Did I eat today?” The answer is probably no. You haven’t eaten in over 12 hours, your socks may or may not match, and your circadian rhythm gave up syncing with the sun two rotations ago.
But if someone—anyone—asks you to explain the Krebs cycle? Suddenly, you're a Nobel laureate. You could draw it on a whiteboard, narrate it backwards, and even throw in enzyme cofactors just to flex.

Welcome to the surreal dichotomy of medicine. Your body may be failing, but your mind holds on to obscure biochemical trivia like it’s sacred scripture. This isn’t just a meme—it’s an identity. It's the living paradox of a profession that trains your brain to prioritize molecular pathways over your basic human needs.

Let’s take a (deep, if you remember how) breath and unpack why medical professionals can recite the metabolic map of citric acid with robotic accuracy, yet regularly forget to eat, sleep, or sit down.

The Medical Brain: Built for Complexity, Starved of Simplicity

It’s ironic, isn’t it?

You’ve trained your brain to instantly recall:

• The twelve cranial nerves and every function they perform
  
  
• All the causes of chest pain, from pericarditis to panic attacks
  
  
• The subtle but critical differences between drugs that end in –pril vs. –sartan
  
  
• Which antibiotics target which obscure gram-negative rods

Yet you regularly forget to:

• Eat lunch (or breakfast… or dinner)
  
  
• Call your parents back
  
  
• Buy new socks (even though the elastic on your current pair gave up last month)
  
  
• Charge your phone or check your email
  
  
• Pick up your dry cleaning—again

This is not laziness. This is a rewiring of cognitive priorities. You’re not built for convenience; you’re built for crisis. Medicine does that—it transforms you into someone whose brain is optimized for survival in chaos, even if it sacrifices your own health and humanity in the process.

The Krebs Cycle: A Symbol of Obsessive Learning

Why does the Krebs cycle hold such a powerful place in your mind?

Because it’s not just a metabolic pathway. It’s a rite of passage. Etched into your hippocampus from the first year of med school, it's your body’s version of muscle memory—but in biochemistry.

You can probably still recite:

Acetyl-CoA → Citrate → Isocitrate → α-Ketoglutarate → Succinyl-CoA → Succinate → Fumarate → Malate → Oxaloacetate

And then repeat.

It’s more than a pathway—it’s your trauma loop. Someone says “rate-limiting step,” and you don’t just recall the answer. You flinch. It’s the biochemical equivalent of a reflex.

Forget your phone? Sure. Forget your wallet? Happens. Forget that the Krebs cycle produces 3 NADH, 1 FADH₂, and 1 GTP per cycle? Never. That knowledge is tattooed on your brain.

Welcome to Cognitive Whiplash

So, how does this paradox happen?

It’s not accidental. It’s a carefully engineered combination of:

• Repetition: You didn’t just learn it once. You reviewed it in every lecture, on every practice test, until it became part of your subconscious.
  
  
• Fear-driven memory: Biochemistry exams came with the same dread as horror movies. You remember it because fear carves memories deeper than calm.
  
  
• Crisis optimization: In clinical life, when everything else fails, your training defaults to what it knows best—facts, formulas, pathways.

So even when you’re dizzy, hungry, or emotionally depleted, your brain is still whispering:
“Citrate synthase. Don’t forget where it starts. You never forget where it starts.”

Medicine Turns You Into a Machine (But a Malfunctioning One)

The medical profession praises perfectionism, applauds sleepless productivity, and views personal needs as optional. Slowly, you start to internalize some dangerous messages:

• Rest is for the weak
  
  
• Sleep is a luxury
  
  
• Eating is secondary
  
  
• Self-care is self-indulgence

Meanwhile, you become a trivia champion of the human body while quietly ignoring your own. You can discuss pyruvate dehydrogenase with enthusiasm, all while nursing an untreated headache and surviving on caffeine.

You become something between a scholar and a ghost. Brilliant, but barely functioning. Memorizing metabolic cycles while forgetting what your own body needs to keep going.

The Clinical Setting: When Memory Outpaces Reality

Picture this:

You're on hour 28 of your shift. Your stomach gave up growling hours ago. Your hands smell like alcohol rub and you're operating on muscle memory.

Your attending asks, “What’s the mechanism of action for metformin?”

Without hesitation, you respond: “Decreases hepatic gluconeogenesis, increases insulin sensitivity, via AMPK pathway activation.”

Two seconds later, you walk into a door.

This is medicine in a nutshell. You are a high-performance machine when it comes to information, and an exhausted, barely-mobile shell when it comes to basic needs. You forget water, but recall side effects of obscure medications.

Exams Build the Memory, the System Builds the Exhaustion

From day one of med school, your success is tied to how much you can remember—not how well you care for yourself.

You memorize:

• Endless drug classifications
  
  
• dermatome maps
  
  
• Risk stratification criteria
  
  
• Syndromes with names longer than discharge summaries
  
  
• Ridiculous mnemonics like “Some Lovers Try Positions…” (You know the rest.)

You are praised not for balance, but for recall. The result? A workforce that excels in intellect and falters in well-being. The very training that makes you competent in the wards also makes you vulnerable in life.

When You Finally Eat, You Still Talk About the Krebs Cycle

Miraculously, you make it to lunch. A rare break. You unwrap your sandwich, only for a colleague to mention cellular metabolism.

Suddenly, lunch turns into a spontaneous lecture:

• The difference between aerobic and anaerobic pathways
  
  
• ATP yields from each glucose molecule
  
  
• Why brown fat is metabolically fascinating
  
  
• Whether ketone bodies deserve more love

You forget to eat again. Your body is starving, but your brain is thriving. Welcome to medicine, where dinner conversation is often indistinguishable from oral boards.

The Humor in the Absurdity

Doctors laugh because the alternative is crying.

• “I forgot my anniversary but remembered the clotting cascade.”
  
  
• “I walked into a room and forgot why—but I remembered the steps of RAAS.”
  
  
• “I need coffee to survive—but I know exactly how it alters adenosine receptors.”

It’s absurd. But it's also a way to cope. Humor is the armor we wear when the reality becomes too much.

What It Really Says About You

Here’s the truth: you're not failing. You're operating under a system that asks for your best 100% of the time—even if you're running on 10%.

You didn’t skip meals because you’re irresponsible. You skipped them because a patient decompensated, a lab came back critical, and a code blue took precedence over your sandwich.

You didn’t miss sleep because you didn’t value it. You missed it because rounds started at 5, and you were finishing your notes at midnight. The Krebs cycle was just collateral brain noise at 3 a.m.

That’s not incompetence. That’s conditioning.

Finding Balance: Yes, You Remember the Krebs Cycle. Now Eat Something.

Let’s be real—knowing the Krebs cycle won’t save you if you faint during rounds.

It's impressive to have recall like a supercomputer. But even machines need recharging. You are more than your hippocampus.

So yes, review your pathways. Be proud of what you’ve achieved. Celebrate your mental resilience.

But also…

Eat.
Sleep.
Hydrate.
Step outside.
Stretch.
Call someone you love.
Take your own vitals once in a while.

Because while the Krebs cycle will live in your brain forever, your body—the only one you get—needs more than ATP.

You’ve earned the knowledge. Now earn the rest, too.