Saturday, February 12, 2005

Old Barbers and Young Doctors

A consultant recently gave us an inspirational talk and opened his lecture with the following quote: "Two people you cannot trust - a old barber and a young doctor."

I'm in my first two months of residency training in one of the biggest teaching hospitals in the Philippines, and in those two months, I have discovered why they call this the PRACTICE of medicine.

It's true, I've been working in this hospital for the past 3 years. I've been through the grueling 24 hour to 36 hour shifts that never seem to end. I've experienced pushing stretchers, doing the most menial tasks, taking precious catnaps on benches or simply leaning against some wall or table. I've seen patients who don't know where to get their next dose of antibiotics get worse and die, patients with neck masses as big as their heads walk in when it's too late for any doctor to do anything about it. I thought that knowing all this, I knew what I was getting into.

But being a first year resident is nothing like being in medical school.

All at once, all the things you thought you knew recedes into the background and everything you know you don't know suddenly takes up center stage. Faced with a patient who hangs on your every word and takes everything you say as gospel just because you're finally wearing that white coat, all five years of learning the science of medicine is negated by everything you didn't learn about the practice of it.

And when you need the most to deliver, you are appalled by the thought that 80% of the time, you're bluffing your way through it and praying with all your might that what you did, what you thought, what you said was right.

Our seniors tell us that everyone went through this, that we all have to start out this way... because medicine is about practice and experience, and that the mistakes we make with our patients along the way ensures that we'll be able to make a difference in more patients' lives in the future.

Still, knowing this in my mind doesn't take away that awful feeling at the pit of my stomach when I realize that I may have sent someone home that I shouldn't have or that I forgot to stop a certain medication that I should have - and I have no way of calling them to give them further instructions. It doesn't stem the should-have-dones and could-have-dones that flood my mind at the oddest moments, and all but drive me crazy.

This is at the heart of my conflict - am I cut out for this kind of life? There are joys, I admit that. I can't deny that I still love the intellectual guesswork, the analysis, and the joy of clinching the diagnosis... but when I add the actual lives that hang on the balance of my thinking process, it terrifies me so much that I don't know if I want to go on doing this at all.

I will not always be a young doctor. And doctors only get better with time. Still, I can't help but wonder if my heart can endure the seasoning it will take to make me a good doctor... or even if it's what really want to be.

In the meantime, I'm taking it one day at a time... and trying my best to do right by my patients - who don't know about old barbers and are trusting enough or desperate enough to put their lives in my young, unseasoned hands.

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