If the hospital could be thought of as a giant wooden clock, then I the intern am the pendulum. Swinging between the raw excitement of finally wearing a long coat one minute–and the frightening realization of my quickly growing role the next. In the hallways when I walk in front of the patient’s room I always take a second to pause and organize my thoughts. Sometimes instead of guidelines and lab results my head fills with the seconds passing by. When this happens my attention shifts and settles on everything around me. Nurses wheel blood pressure monitors assuredly to their destination. Medical students enthusiastically huddle in the corner and go over H&Ps. Attendings laugh and catch up with colleagues about recent meetings. Much like a clock the cogs of the hospital do not fail to turn. It is only me that seems to have paused. I urgently remind myself to keep walking–a long time ago on a college campus I learned that a pendulum must never hesitate to swing if it wishes to keep moving.

The days in the hospital aren’t bad. As a medical student I had my fair share of worries about walking onto the floors and having to manage DKA or run a code. Obviously the supervision wouldn’t let me tackle those alone, there’s plenty of help when you need it. No, it’s when I get home and finally catch my breathe that the day’s events begin to catch up with me. That’s when I think back to all the people I’ve just seen and decisions I’ve made. Did I do right by them? Was there something else I should have done? Is there something I can do better?  That’s the difference it seems between now and only a few months ago. Your decisions have an impact. You can make one without even setting out to do so.

Don’t study to pass tests, study to heal patients

I remember hearing that with my chin lazily resting on my hand, using my worn backpack brimming with pens and review books as a cushion. Some days it would hit home–other times I pushed it out of my head so I could focus on the moment. Now every morning when I pull into the parking lot and the grumbling from my old car dies down, all that’s left is a hospital against the orange-blue horizon and patients that need to be seen. There’s no classroom anymore and no answer section at the end of a chapter to flip to. The only thing I carry now is the heaviness of lessons learned and the anticipation of those yet to come–and my beeper.

In the end it’s all very exciting; putting to practice the knowledge accumulated over years feels satisfying. Going through patient charts and piecing together a story really does make you feel like a detective. Talking to patients and providing relief just through what you say is both surprising and humbling. Everything people said that was great about medicine is coming true–I’m grateful to be here.

However, so are the words of warning and tales of caution long-since spoken.  I stand before a steep learning curve as an intern, with mounting pressure to reach the top. Autonomy and competence are my goals; guiding me are my own experiences and the knowledge recorded by others. The greatest gift though is the chance to see patients. They are the numbers on the face of the clock, everything exists to serve them, and I the pendulum swing steadily on.

He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all. – William Osler

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2 Comments on "The First Week of Residency, The Weight of Responsibility"

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www.BecomeAHospitalist.com
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www.BecomeAHospitalist.com

Very nice. Here are some tips for new docs. http://www.becomeahospitalist.com/tips-for-new-doctors/

Deeksha thorat
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This sure sounds dreadful yet inspirational. Looking forward to reading more such experiences!

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