I understand that I haven’t posted in a while, and life has been a little crazy with this residency thing. Nevertheless, I’m back and committed to putting out regularly scheduled material. So let’s get to it.
So you graduated in May, and everyone is calling you by your DESERVED title of "Doctor”. You’re smiling and still in shock that 4+ years have zoomed by with you still maintaining your sanity. You passed numerous USMLE exams and walked across the stage in front of family and friends. You earned this accomplishment, and you deserve to bask in the glory.
Fast forwards 6 months later. You’re half-way done with intern year, and you finally got comfortable being able to manage blood pressure and diabetes medications. You wake up at 5:15 every morning and get to work by 6. It was your turn to pick up the pager, phone, and collect sign out from the overnight intern. While looking at the list, you notice you have 6 new admissions from the night shift, and everyone looks unstable. After chart checking, adjusting medications, you start getting pages and calls on the phone. Nurses are asking about things that you didn’t even know was going on with your patients. As usual, you go and see all 10 of your patients with the intention of things being under control and no one wanting to ask you 20+ questions. Now you’re rushing back to talk to your medical students, your upper, and get some sort of grasp of what needs to be done. Before you can finalize your “idea” of a plan, your attending walks in ready to get down to business. As the team table rounds, your phone goes off. You answer it, tell the nurse that you DID want that lab, and return realizing you missed the entire plan. The phone rings again. You answer and come back to yet another missed plan on YOUR patient. The phone rings again, again, and again. It’s not even 10am, and you’re already behind.
This routine continues 6 days a week for 4+ weeks at a time. I’m not going to lie, I hit a point where I completely hated going to work. Since the age of 7, I was the child who wanted to become a physician so I could help others. As I matured, I realized the inequities that exist in healthcare and how it disproportionately favors assisting those with money or status. My background is not one of money or status, and I wanted my future patients to know that their wealth was the least of my concern. I had worked so diligently in school to be able to care for those that society often left behind, and somehow, I had reach the point where I hated coming in to work. What happened?!?
Fatigue, stress, feeling overwhelmed, lack of self care, and feeling as if I couldn’t voice my opinions without possible ridicule/judgement all resulted in me feeling disdain. I didn’t know what to do about it, and it probably was plastered on my face at times (I have facial diarrhea or RBF). I had the common sense to know that patients (regardless of my mood) deserved to have a physician who was attentive and considerate of their needs. So I poured all that I had remaining into having amazing patient rapport and ensuring they received above and beyond care. However, in the background, I hated everything else related to work. I want to clarify that I didn’t hate my team (they were amazing), but I no longer got joy from coming to work. I get that everyone has days when they’d rather be at home watching Netflix or on vacation, but usually my mood changes once I see my patients. This time was different. To be honest, I was depressed and pushing through it without tackling the deeper issue.
As I said on my IG post, a faculty member that I respect pulled me to the side after my rotation was over and asked about my general well-being. She was concerned about “burn out” and its effect on my residency experience. I looked shocked that she wanted to have this discussion. I mean, who isn’t burnt out as an intern. We hear that everyone goes through it. It’s a “rite of passage”. But she was more worried that I wouldn’t be able to reset and get back to being my outspoken self. We discussed my support system, work issues, mentorship, therapy, and realizing when I need a break. I’m a type A personality; I refuse to be viewed as mediocre when it comes to any aspect of my life. Stress was mounting, and I was just chucking it on my back and powering on. That’s what a lot of us have been taught (correct me if I’m misinformed). She told me that I was critiquing myself to a higher standard than anyone would ever expect of me as an intern. But how could I tell her that I was accustomed to the mantra of “you have to work twice as hard to be seen”? She listed to my concerns about not feeling ready to become an upper resident in a few months, and told me that I don’t have to beat myself up over not taking my USMLE Step 3 yet.
In 30-40 minutes, this faculty member got me to realize that I deserve to be happy in residency. I understand that it won’t always be easy or fun, but I matter just as much as my patients. I am allowed to be human and express my concerns without fear of being deemed a “complainer”. She reassured me that I was chosen for this IM program because they loved my personality and didn’t want me to quash it or any aspect of myself in order to be a great doctor. She allowed me to understand that self-care (while being a resident) does not equate weakness or an inability to handle the work. I write this to show that it’s okay to not like everything that’s going on, and you don’t have to feel alone while serving others. There is a larger community available for you to voice your thoughts who understand what’s depicted in the media isn’t the entire picture. There are low points that happen in residency no matter how much you work, and it’s not a stain on your ability as a physician. But being able to admit these moments and working towards changing them is what shows your ability to look after the most important patient you’ll ever have, YOU.