Sunday, August 16, 2015

Last Complete Week of Vacation



One day next week  --  I'm not yet sure which day -- I will return north to our condo and to Quarter 3 of the pre-clerkshi[ program of medical school.  I will go with much less trepidation then I went last year. I didn't even admit in my blog that  I was there last year until I'd been there a solid month and knew I wasn't going to flunk out in the first quarter.  I'm still afraid of what lies ahead, but the fear does not paralyze me any longer. It's merely a matter of accepting that someone  will dies in spite of everything I do, and chances are that somone will die sonner or later because of what I did or did not do.

I hate to think that I will inadvertently cause the death of a patient, but the odds, I've been told, are overwhelmingly in favor of it. A future physician or surgeon has to hope that the person whose life his or her actions ends didn't have too much time left on the planet. Also, one has to hope the malpractice insurance that comes with medical school or internship/residency is as good as one was told it was,

Even House of House, M.D. fame lost a patient once in a while, and that was in TVland where everything has a happy ending unless it's a really depressing program. i like the idea of being a doctor. I'm just not sure hw much I'll like the responsibility that comes with it. My instincts tell me that someone from my generation has to step  up and control the scalpel or prescription pad or whatever, and on paper, at least, I'm more qualified than most. I still have a fear, though, rational or otherwise, of what's going to happen when the buck actually stops with me.

This summer has been nice and low-pressure. I've been totally responsible for two different babies at various times, but help was never much more than five minutes away if I had needed it, and I was fortunate enough not to need it. Caring for the babies has given me confidence in providing health care  for  babies and even children to a degree, but I'm scared to death of the time when a 55-year-old heart attack patient is wheeled through the E.R. doors and right at me. This year I'll see some of that, though I won't be responsible for making any decisions.

I've been told that third-year medical school is the second hardest year of a doctor's life, second only to internship or the first ear of a residency. People say to enjoy this year because it's the calm before the storm. I would enjoy this year if i were not so terrified of next year. On the other hand, who really knows if next year will ever come? At mass today the priest's homily dealt with time, and the inly time we're guaranteed is this moment. It makes no sense to waste it worrying about future difficult moments.  Still, I worry anyway.

11 comments:

  1. You'll make it... because you have empathy for people like me, who avoid doctors like the plague. ;)

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    1. Yes, I can empathize. i know how much I hate being a patient, and i understand that most of them would prefer just about anything to undergoing medical tratment at a given time. I understand white-coat hypertension (though I must be cautious not to overlook bona fide hypertension by writing it off to being the white-coat variety) and over time I will develop the instincts that allow me to know which parents are being straight with me when they say their pressure was 120/70 at home that morning and which patients are not reporting truthfully because they can't even, themselves, admit and deal with the idea that there is a problem that really needs to be addressed. that takes time.

      At first you believe everyone or no one. Then yur instincts get better and sharper, though you still miss a few. Eventually you hope to inspire enough trust in a patient that he or she will give straight answers to you, but you have to assume that what you hear isn't necessarily 100% the gospel truth and go from there.

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  2. Familiarity is a valuable asset. This is especially true for those of us who fall on the more neurotic side on the personality scale. I also think a lot of times we view anxiety as a hindrance, but it also lends to careful thinking and consideration. Obviously there can be negative consequences to both too much familiarity and anxiety ... an overabundance of either can lead to bad outcomes, whether that manifests in disregarding important details because we believe that we know a pattern or aspect more than we are capable of knowing, or we freeze and are unable to process - we overthink and cannot decide. I suspect that you will continue to strive off arrogance and embrace humility. It is a virtue that not everyone is equipped with, however, as Knotty acknowledged, you have empathy and understanding.

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    1. At this phase of my career, I can say with honesty that I haven't a single atom of arrogance in me. I may have had the slightest bit of it upon seeing my MCAT scores and even at how easy it was for me to get interviews at the schools where I wanted them, but any arrogance I ever possessed disappeared at the very first med school interview. I saw how little power I had and how everything I had done to prepare for med school was nothing to many of those people interviewing and judging me. Even if my scores and qualifications on paper were higher than 99% of all the other applicants (which they clearly were NOT; such would be an unrealistic expectation, though I would have to have been considered in the upper 5 % of the application field by measurable qualifications alone) it's those immeasurables and intangibles that make the difference sometimes. Others around me may score lower on tests but have an air about them that inspires confidence from patients or makes someone want to hire them.

      I'm lucky in that, while I will have to sell myself for a residency or internship, and it may be a pretty hard sell, I have a job waiting for me afterward if I still want it. Sooner or later I will look older and people will not assume that I'm too young to be wherever it is that I am.

      I noticed that most of us in the class have obstacles. Mine just don't happen to be in areas of difficulty mastering most of the academic content thrown at us or willingness to put in the hours that it takes to over-prepare.

      One of my advisers told me that 3rd year is going to be easier for me than for some because I put in so many hours already. He also said that a somewhat pessimistic attitude, or -- at the very least -- a realistic one, when not shared with a patient, can cause a practitioner to cross every i and dot every t and be more thorough than a health care practioner would otherwise be. You can't share that with a patient, though. You have to call on whatever acting skill you can muster in order to exude confidence from every pore when in the presence of patients and their families.


      i do think my time spent on the other side of the medical spectrum -- as a patient -- gives me valuable insigt that doesn't translate into higher test scores but does giv me valuable insight as to where a patient is coming from, what he might be thinkiing or feeling, etc. But any new doctor who doesn't deal at least a bit with self-doubt is probably a doctor I do not want treating me. I possess at least the required minimum of self-questioning. I've seen just enough to know how much it is I really don't know.

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  3. Keep the self-questioning. Self-questioning is conducive to growth. Do not confuse this with self-doubt which will inevitably arise at some times.To acknowledge that there are things that you really don't know is the beginning of self knowledge. The next-vital-step is knowing who to seek out to help you with the gaps in your knowledge.

    Glad you had a good summer playing with "your" babies. Winter is still upon us with summer only a distant hope away.

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    1. I keep forgetting that half the planet is dormant now. Are the winters harsh where you live?

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  4. Far from harsh. We have a California-like coastal climate. Our nearest snow is 1,000km away necessitating a long journey.(just had a great week skiing!!!). This winter has seemed unduly long as we really didn't have an autumn. We went straight from a record hot summer- 40 +degrees C is not unusual- to an unusually cold winter. Cold for us is 6 degrees C overnight to 10-12 degrees C daytime. So nothing really to complain about, but winter everywhere is still winter and one longs for spring.

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  5. One thing that you can be certain of is that you will die. That is the only thing you can be certain of. But what is the purpose of life? It is to feel happiness. You can not feel terror and happiness. What you need to do is to get rid of terror. It is a sin. So is worry.

    It is easy for you to not kill anyone or not to steal anything and I do not think I need to worry about you worshiping an idol. But trying to not worry is not so easy of a thing. Jesus says "Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own."

    Matthew 6:25-27 “Therefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing? Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they? And which of you by being anxious can add a single hour to his span of life?"

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  6. I'm quite aware of my own mortality.
    I agree that happiness is about as important as anything.being happy and living in such a way that allows others to be happy is my goal in life. Practicing medicine and or medical research will, i assume, be a part of that.

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