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There's always been a certain glamour to the medical field. And there has to be, because the exhaustion that sets in at about the 20th hour of a 30-hour shift is much more easily endured if you can see what would otherwise be just a job as something more—something closer to a calling.
At least that's what they tell new doctors, like me, as we embark upon residency training. Just over a year ago, when they welcomed our pediatric intern class to Children's Hospital Boston, we were asked to look to either side of where we were sitting, not because (as so often happens in movies) one of those people wouldn't be there when the three years of training was complete, but because these strangers were sure to become our closest friends. It was in this spirit of camaraderie that we 20-somethings gush at each other in much the same way that we coo over the infants we care for. Just as we say, "Look how she lifts her neck up on her own!" to let a new mother know how amazing her newborn is, we constantly tell each other "You're doing all right." It is something we all need to hear.
So they promised us friendships. But what they didn't say in that first week of orientation was that part of the reason our fellow residents would become so important to us was because it's so difficult to translate our experiences training at the hospital to those at home. When I started my internship, I had been married just 23 days. I didn't want to have to exit the new life I'd just begun, and while I certainly expected that training would be hard, I hoped that there might be a balance and a way to easily bring the self that I was becoming as a doctor back to the people who already knew me as a daughter, a friend and, now, a wife. But, medicine has a language all its own, and despite the good intentions of my parents and husband, sharing the day's events with them has become a challenge. So, eventually, we residents started to just talk to each other about our lives in the hospital, using terms like NAS, PPV and flog, knowing that we wouldn't have to explain what we meant.
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A good example of when the old me, and the new doctor-me came into contact was when I did my first lumbar puncture, (LP). An LP is removing a spinal fluid for testing and they say that the key to a successful LP is in finding a nurse or other helper who has been through the procedure so many times they essentially place the baby on the needle for you. Certainly, it's essential to know the landmarks of the child's back and where the needle should be aimed, but there's no amount of careful plotting or running one's finger along the infant's spine that compares to an experienced doctor's or nurse's ability to hold a shrieking child still in such a perfect curve that the cerebrospinal fluid easily comes dripping out. It's one of those procedures at which pediatricians are expected to be proficient, so I'd developed no small amount of anxiety around the fact that I had yet to perform one.
When it was over, it was a significant triumph, but it came with conflicting emotions. I was, I fully appreciated, not the person in the room who was most qualified to do the procedure. That person was standing just behind me. But it was not her hand that advanced the needle forward and between the bones in the infant's back. So I owed as much gratitude to that patient and her family as I did the physician who patiently coached me through it. When I told my mother about the procedure, she thought I'd been allowed to watch it, as it had never occurred to her that I might be the one to do it. I realized then that it's going to be hard for my friends and family, who've known me for so many years, to look at me and see a competent doctor, just as it is sometimes hard to see that person in myself.
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Now, more than a year later, it's a transition that's still not fully complete. My mother-in-law has only recently realized that every fourth night, when I'm on call, I'm actually in the hospital seeing patients and doing paperwork throughout the night—not home in bed answering the occasional page. My husband is still unable to wholly maintain his attention through my rambling expositions on how a challenging diagnosis was finally made. They're still learning and so am I. During the next two years. I'll have to make decisions about possible fellowships or, terrifyingly, apply for a proper job. There's a long way yet to go. I still sometimes catch sight of myself in a mirror at 4 a.m. and see an unfamiliar doctor's face. And I still silently apologize every time I slip a needle beneath a child's skin, not only for the pain I am causing, but because I know that I am not yet the doctor I hope one day to be.
More In their own words:
October 2007: The Office of Child Advocacy
August 2007: Patient Relations' Kitty Scott, RN
July 2007: Peer leaders from Children's Center for Young Women's Health
June 2007: Amy Litterini thanks Charles Berde, MD, PhD for his help in an in-flight emergency
May 2007: Martha Eliot Health Center's Robin Crowley, RN
April 2007: President and CEO James Mandell, MD
March 2007: Parent Anne Renk
February 2007: Ophthalmology patient Regina O'Neill, PhD
January 2007: Urology's Michelle Simon is inspired to give back to Children's
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