To say I was scared on the eve of July 1, 2017, would be a gross understatement of the truth. It was the final night before I would don the long white coat laden with the weight of real responsibility in addition to my lightly used stethoscope. I was paralyzed by a profound, gripping fear that lived deep in the pit of my stomach. That fear took residence down there and would manifest itself by synching the muscular walls of my gastric mucosa, twisting it into pretzels. My jaw remained clenched and my teeth would grind. Sleep was elusive and when it finally came, it was rudely interrupted by dark, vivid visions of me by the bedside of a sick patient, standing there blankly and having not the faintest clue of how to proceed.
A good friend, Ben, who attended the same med school as I but graduated two years ahead of me, was starting his third year of residency at the institution where I was about to become an intern. On one of our numerous phone conversations prior to my July start, he said to me, “Starting intern year is a little like going to war. You trained for this, you prepared for this, but it will be unlike anything you’ve experienced before and it will be harder than most things you’ve ever done. It will also be doable. You just need to keep your head on straight and know when to ask for help. There will always be help. You are never alone.”
His words and constant reigning in of my anxiety was welcome and necessary. I would come back to those words again in that last night before heading into the hospital on July 1st. In addition to not knowing basic things, like where the bathroom was or if the stairway door was a push or pull, there were also the more serious shortcomings. “Doc, the patient is hypotensive, what do you want to do?” ‘Hypotensive? Oh, jesus. Is it poor form to whip out a book? Wait, wait, let me up-to-date this.’ Like everything else in life, exposure therapy is key and when I am now faced with that same scenario, I remain quite calm and rely on my previous experiences to guide how I proceed. Ben was right, you are very much going to war; you are on the front lines and while you have basic training under your belt, with your honors and your AOA certificates decorating your wall, you have never done the real thing. Until you do.