(Unedited rambling ahead)
Today my med student was looking really dysphoric on rounds so I asked him what was wrong. He told me he was feeling really hopeless about how hard it is to help the people under our care on the inpatient unit.
I decided to sit him down to talk about it. He brought up time constraints, space constraints, financial constraints, energy constraints. He talked about his patient that he just feels would really benefit from hours of daily psychotherapy from a really skilled practitioner. Etc.
And my first instinct was to come up with ways in which this patient didnât need that, to think of the ways we really are helping people, etc. Because those are the answers that have been given to me for years when I ask the same questions. Because those are the answers that help us sleep better at night and come into work easier in the morning. Because those are the answers that alleviate our feelings of horror and guilt.
But I stopped myself. Because I donât think those answers are true or acceptable; Iâve been rejecting them for years. Thereâs never been a time in my life other than right now when Iâve longed to internalize them more. And thatâs a big part of the reason this first month and especially these last few days have been so tough. And it was really surprising to me how in that moment â talking to a student, someone Iâm meant to be mentoring â it suddenly would have been much easier to say that stuff, and for a split second I almost did. But I canât.
So I said, âI know, right?â and âIt really sucks.â and âIâve struggled with these feelings too, for a long time.â I told him how itâs especially hard now as a resident when Iâm in a position of slightly more power and responsibility but with even more bullshit to wade through. I told him how hard it is to find a balance between perpetual outrage/frustration and self-care, but he had to try.
And then I told him that even though it sucks, that doesnât mean itâs hopeless. Every day we can be better for our patients: I talked about two examples of improvements in my own practice with specific patients that Iâve worked on already in this first month. And every day we can keep our eyes on the long-term: we can work together, slowly, for real progress.
Afterwards I realized that nobody had ever done that with me as a med student. People at the hospital hadnât really been concerned about making sure I was okay. So even though itâs monumentally frustrating to call this my biggest success of the day when I wish it was something bigger and directly related to patient care, Iâm gonna take what I can get.
Iâve been here for a month and one of the positives here is that Iâm feeling suddenly like I have so many people that care about how Iâm doing, and that want me to be healthy and up for this work. And theyâre people IN MY FIELD! My senior big sib took my aside yesterday and helped me process one of the really terrible things that happened on my call shift. My previous attending saw me in the hall and asked me how I was doing and followed up again today. A med school friend texted me today asking me how I feel about doctoring today.
One factor in this is that the last few months Iâve gotten much better at just being vulnerable with people, because there was no way around it given how ripped to shreds Iâve been. And so Iâve made it a point to be honest when people I respect and like ask me how Iâm doing. Itâs the first time in my life Iâve ever done this.
Maybe thereâs a future where I wonât just have to go home and vent to Lumberjack and @mountainlamb and my mom â maybe Iâll have people to help me work it out on the job, to help me troubleshoot and make things better. Maybe Iâll have teammates.
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