This time last year I was dressed in a cap and gown. A silly grin plastered across my face. Tears of pride streaming down my mom’s cheeks. Degrees were earned and delivered. Photos snapped. Celebratory dinners were had. The following day, however, as the haze of excitement began to fade like my recollection of the Fick equation, I was left with a different type of hangover. My mind now free from the pressures of step exams and clinical rotations, made room for a new anxiety to set it: in a few short weeks I would be starting residency. I would be a real doctor. That long white coat I had so desperately coveted would soon replace my dingy short one. Along with it, a weighty responsibility and expectation would be thrust on my shoulders. I was petrified. No longer could I answer my patient’s questions with, “Oh, I’m just the med student.” What if a patient becomes septic? What do I do? How will I respond in a code situation? Will I be able to identify a STEMI? A stroke? Can I handle that? Am I smart enough? Am I prepared for this? These ’what if’ scenarios kept me awake at night… and made my final weeks of freedom a mental prison.
Now, as I sit and write this almost a year later, hardened by my long days and nights on call, the answer to many of those questions surprised me. Am I able to correctly respond to all of those ‘what if’ scenarios? No. I am not. I am still learning. But interestingly, and perhaps more importantly, those ‘what if’ scenarios no longer keep me up at night. I have experienced and learned enough to know what I can and cannot handle on my own and I’ve also come to recognize that in those instances when I am in over my head, there is always going to be help.
Learning sick versus not sick is a skill that intern year will teach you time and time again. It is that invaluable delineation which creates the first and most critical fork in the road. Do I need to get help or can I handle this on my own? You will ascertain and intuit this skill as you make your way through intern year. It becomes an instinctual ‘gut feeling.’ You will be able to get that pit in your stomach, telling you to keep an eye on that patient in bed 12. It will make you re-page that consult. It will entice you to go back and lay your hands on their knees and recycle their BP. And you will start to listen and embrace that gut feeling more and more–as I plan to do with each and every patient encounter I participate in.
Intern year has taught me a lot, ‘sick versus not sick’ I continue to hone. Perhaps, though, the greatest lesson I learned is that my trepidation and crippling fear was unwarranted as it should be for you. There will always be someone to ask for help: just trust your gut.