First day

Tomorrow is my first day as a resident. Orientation finished last Friday.

I’m nervous and feeling like a big odd ball of emotions: relief, terror, gratitude, awe, and incompetence are the first few that come to mind. How do people ever become “real” doctors, anyway? In med school, being a “real” doctor meant being an MD. Now it feels like you should know what you’re doing before you can call yourself that. When I see “Physician” on my nametag, or hear people refer to me as doctor, I want to correct them, “Oh, but I’m not a REAL doctor yet.” I hope I don’t cry when I see my first patient, haha  

Really though, I’m so happy in my program so far. I was skeptical when I finished the interview day here, wondering if they were just saying all the right things to sell us the program. But I have a good feeling about it all. Their emphasis on communication, their attitude and approach, so patient-centered and wholly supportive of everyone. I was looking for a family-feeling, a new team, a new home, and I may have found it. I’m buying into it all and I feel the other interns are too.

Anyway I’m terrified, nbd. Wish me luck.

Almost done, about to start

I’m in my last two weeks of med school. Where has time gone? Sometimes it dragged on so slowly, and now it’s all a memory. Amazing!

I’m doing a rotation in Preventive Medicine and honestly, it is so much of what I wanted to do medicine for and was waiting for through med school. Still, I’m realizing I do really love seeing and helping individuals and will always want to keep my clinical skills part of my life too. I’ve got ideas and questions filling my head, all about my 5, 10, 15 year life plan but I know that I’ve still got so much more to explore and experience. I’m re-learning how things do unfold in special ways, so long as you listen to how things make you feel.

Med school is almost done but I’ll keep this blog because I don’t think I’m done reflecting just yet!

With a growing …

With a growing avalanche of new knowledge and skills bearing down on them, they feel increasingly overwhelmed by what they do not know. They soon discover that, instead of expanding their capacity to make a difference in the lives of others, the rigors of medical school have constricted their field of view to their own survival.

Burnout at its deepest level is not the result of some train wreck of examinations, long call shifts, or poor clinical evaluations. It is the sum total of hundreds and thousands of tiny betrayals of purpose, each one so minute that it hardly attracts notice. When a great ship steams across the ocean, even tiny ripples can accumulate over time, precipitating a dramatic shift in course. There are many Tertius Lydgates, male and female, inhabiting the lecture halls, laboratories, and clinics of today’s medical schools. Like latter-day Lydgates, many of them eventually find themselves expressing amazement and disgust at how far they have veered from their primary purpose.

Quote from The Atlantic article by Richard Gunderman, “For the Young Doctor About to Burn Out.”

Lucky in a way

I was sad a few weeks ago as I prepared to leave Brooklyn for Hamilton for a month.

Now its coming into my last week in Hamilton and as I see old friends, I’m sad again to go.

Just like the child who cries when leaving for camp, and is crying coming back.

I wondered tonight if this lonely feeling is sustainable. But on the other side of feeling sorry for myself, is the fact that the painful feeling of missing people and places can be a blessing; a reminder not to take people or good memories for granted.

When you feel like you don’t want to leave, wherever you are, it’s lucky in a way.

I stayed up late

to catch the 10:30pm lane swim. In the locker room, the 2nd years still decorate each person’s locker, and there’s a list of goals hanging on the wall, like back when I was there. The showers are still flooding and the walls are the same yellow. Even the paper signs saying not to hang wet bathing suits on lockers are still there.

Walking home, I was thinking about people I know and love around the world, and how we’re not really that far from each other. Many of them are sleeping at the same time, maybe as I was walking home even. I have about a week and a bit left here in Hamilton, and it has flown by, like I thought it would, back on my 3rd day.

I turned onto my street, which was dark, porch lights were off. Not for the first time since being here, I noticed the stars in the sky, which were shining on the dark dark blue. A couple constellations, but enough to make me catch my breath – has it been that long since I’ve seen the stars like that? I guess so. I felt instantly smaller and connected, and for the first time in a while, wasn’t thinking about the future or the past. 

Feedback

When I was swimming, I loved getting feedback on my strokes. It meant I was getting attention and on my way to perfecting my technique. The more the better!

Now in clinicals, when I learn a mistake I made or get a question wrong or it turns out I overlooked something, I feel bad. At the end of the day I’m sighing and trying to relax about it all.

How come I’d be so happy to hear what i was doing wrong when it came to swimming, but not when it comes to smarts? With every comment or lesson, I felt like I was getting better, but in medicine I have to remind myself it doesn’t mean I’m a poor student or going to be an incompetent doctor.

 

Weekend

As bad as the week seemed, it was really mostly trying to figure out the expectations they had for me.

Funny how the marks really don’t matter at this point. Applications are in, even interviews are finished. It’s pass fail, anyways. Yet I still can get so anxious about doing well, whatever that means.

It’s surprising how easy it is to go about more or less living on your own, not really talking to people very much in the days. But I’ve been living in my head a lot, and I’m gonna see about getting out of there a little more often.

Ahh, I love the weekends though!

The problem,

The problem, often not discovered until late in life, is that when you look for things like love, meaning, motivation, it implies they are sitting behind a tree or under a rock. The most successful people recognize, that in life they create their own love, they manufacture their own meaning, they generate their own motivation.

For me, I am driven by two main philosophies, know more today about the world than I knew yesterday. And along the way, lessen the suffering of others. You’d be surprised how far that gets you.

Neil deGrasse Tyson

http://bestofama.com/amas/qccer#c3wgffy

Home again

I’m back at my alma mater for a rotation.

It’s been really interesting to see how it’s done in Canada. I’m at a new hospital, at an academic center, with slightly less sick patients, so it is a biased look, but hearing the great talks and hallway lectures from the attendings about research and studies, and questions still unanswered, has reminded me of how fun and exciting it is to do research, and to have a project that you really own and shape.

I was pretty sad this week, as I thought seriously about whether to go back to Canada or the US for residency. Even though I’m back “home” where I lived for 6 years, being away from NYC, which has been home for the last year and a half, has me feeling a bit lonely as I get used to my new placement. I felt sad thinking I might feel lonely the next years, through residency and potential fellowship, as I keep moving place to place, and still don’t know where I want to and where I can or where I will settle and make my home.

But I just got to keep reminding myself that things change, and to enjoy this moment.

It’s snowy outside, and pretty cold, but life is good.

Halfway through sub-i

Well I’m halfway. Last week I worked every day of the week. A patient coded while myself and my co subi were alone on the floor. Backup came, of course, but it was terrifying nonetheless. Next time we’ll know what we can do, instead of just auscultating while the patient is struggling to breathe.

I’m getting into the flow of things. Said bye to some patients I’ve grown fond of. One patient has her adult daughter by her side almost every moment day and night. Her daughter feeds her, changes her diaper, and keeps her company all through the night. I felt happy and sad to see them go. Will I get to ever know what happens to them? That’s goodbye for real?

I feel like a job is done when patients leave, but really its just that my part is done. They are rarely completely healed, just stable and safe to go home.
It feels good to feel myself becoming more efficient, less afraid, growing. But I also feel myself hardening a bit. Like things don’t affect me as much. It partly comes with experience I guess but mostly just helps to work faster. There are limitations to hospital care and as much as I love the pace and intense patient care, and I love the interdisciplinary work, but I also feel sometimes like just a pit stop or a bandaid. Are the changes I make going to impact their health down the road? Will their primary care doctor make any changes? Will they follow up? Are they any more healthy?

Two Mondays to go.