The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Monday, November 21, 2005

Grey's-Anatomy-Inspired Thought of the Day

The moment between George and his father as he was picking shotgun shells out of his father's ass made me think. A lot of people assume that if you're a doctor you're confident. Overconfident, in some ways. But sometimes, a little approval from someone whose opinion means a lot to you means the world. We spend so much of every day feeling completely incompetent and stupid that 'confident' does NOT describe my impression of my own intellectual abilities. On most days, anyway.

Today I spent the entire day in a state of panic. Even after three weeks and four nights of call, I still feel like I'm in WAY over my head in general surgery. Today, a patient got sick. When I say 'sick', I mean this poor man spent the better part of the day actively trying to die. I was called when his O2 sat dropped below 90 on 50% oxygen. For the next two hours, I tried everything I could think of. All of my seniors were in the OR, and my staff didn't seem nearly as concerned as I thought she should be. Finally, after watching his sats fall to 87% on 100% O2 as he panted like a dog and started to get obtunded, I called the staff and told her quite bluntly that I was not comfortable managing this patient on my own and that she'd better get her butt up to the floor ASAP. Maybe not my exact words, but at that point I was on the verge of needing a new pair of scrub pants.

In the end, he ended up intubated in the ICU. I don't know what I would have done had he crashed in front of me. I've never run a code, and I am petrified of my first time. Will I know what to do? Will I be able to be calm under pressure? Will the patient die? Will it be my fault?

Try to imagine feeling like this EVERY DAY. Welcome to the life of an intern. I've developed heartburn, which I've never had before. It usually hits around midafternoon, the peak of my day. I'm nauseous constantly. I rarely eat anything solid past breakfast because of it. My sleep (when I get it) is irregular and punctuated by odd dreams of the hospital. I'm lucky if I see the gym once a week. I've never known this kind of stress for such a long period of time. Can I really survive two months of this?

So yeah. Doctors (or residents, at least) DON'T think they know it all. We don't think we're smarter than everyone else. In fact, when you have so many incredibly intelligent people making you feel stupid it's hard NOT to believe it after a while. So if you know a doctor, be nice. We're fragile.



Anonymous Anonymous said...

I like your human side - don't ever lose it. Why you would want to put yourself through this? That, my friend, is a whole other issue. It sounds horrible. As bad as it sounds, it probably feels worse when you are in the thick of it, but when you get through, I am sure you will feel an immense sense of accomplishment.

10:32 PM

Anonymous Anonymous said...

I, personally, think you young doctors are beyond special but I'm an old thing who is horrendously biased...IYM

12:42 PM

Anonymous ron said...

hang in there. but remember you are are not perfect. you WILL make mistakes. sorry, but its true. none of us live forever. we die.. you will see people die.. some will die no matter what you do. but for others you will be able to buy them extra years..1,5,10, 20, 30 or maybe longer...some people will treat you like crap. others will treat you as a god...when you lose someone, just remember has been on this earth for thousands of years. modern medicine can do things never seen thankful for those you can help. mourn those that you lose. but no matter what..HANG in there..we need you

8:23 PM

Blogger M. Dyspnea said...

I never used the phrase "trying to die" until I worked in the Unit for a few months. I coined it for myself after a CF patient dropped sats to 50% three times in two hours. It made me never want to work in the ICU again. Still, I laugh every time I think about that phrase and how after some time I really started to think that way. Why is this person TRYING to die? Don't they get tired? Morbid, I know.

7:11 PM


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