The Boss

It's easy to lose yourself in residency.  Very easy.  You get forced into doing a lot of things you don't like nor want to do.  Things you don't envision yourself doing in the future, therefore feel pointless.  Things you "didn't sign up for". Things you don't enjoy.  Things you lack not only confidence in doing but the motivation to learn to do it.  You are forced into these things, time after time.  For hours, upon hours, upon hours.  You get pummeled. You get beat.  You lose sleep.  We often refer to the weekend shift on Medicine as "going to war". So, like I said, if you are not careful, it is so very easy to lose yourself.  To question what you are doing.  To doubt your decision to be a physician.  To wonder if it would be best to just quit, and suffer through a life of student loan debt over continuing one more day in the trenches.

Then, it happens.  You have a moment.  One of those extremely rare, but oh, so powerful moments, that wipe the entire slate clean.  A moment that gives you a glimpse into the future.  Where you are a competent, respected, trusted, appreciated, appropriately worked and rested physician.  You are someone 100% confident in your abilities and decision to become a doctor.  I recently had one of those moments.  In the Emergency Department of all places!  (If you didn't know, ER physician was probably the first and only specialty I rotated in as a student that I could [and did] without question, absolutely remove from my differential as future career.  Hate it.)

It came 15 minutes before the end of my 12 hour (felt like 3 days) shift.  A podiatry resident was headed into the room of an extremely nice, clean, sane elderly lady with a nasty foot infection.  This lady was accompanied by her loving husband and worried daughter.  He planned to incise and drain the wound in the ER.  I asked if I could join him.  Not only did he let me join, he offered me the procedure!  Suddenly, my long, boring day, filled mostly with drug seeking, menial complaints, had the opportunity to be salvaged. Despite putting my arrival home off by 45 minutes, I accepted.  When I entered the room, the patient and her family very respectfully referred to me as doctor.  They wanted to be sure they could pronounce my name right, and asked me what year I was, and if I'd ever done this before.  They asked details about the procedure, the plan for when it was done. I love it when patients take an interest in their health.  I love it even more when I can answer all their questions, confidently and correctly.  One nurse gathered all the supplies and stayed to assist, soon, another nurse entered, pregnant and due any minute. She asked if she could stay to watch the procedure.  The patient joked and said, only if you promise not to deliver a baby while doing so.  I then joked that it wouldn't matter, because I could deliver the baby too.

Halfway into the procedure, one of my fellow Family Medicine residents arrived at the scene to begin interviewing and admitting the patient to our Medicine service.  A job I had just been doing the week prior, while on that rotation.  At that moment, it dawned on me.  I was THE BOSS.  I was the most educated, well rounded, able-bodied person in that room.  I was the only one in there (until my resident buddy joined us) not only capable but qualified to take care of everyone's health needs in that room.  The podiatry resident knows feet.  The nurses know before and after care.  I can I & D, deliver a baby, and manage the patient's many additional health problems and illnesses. If her heart had stopped (and thank God it didn't!) I would be the one expected to run the life-saving code.  This, my friends, is exactly what I signed up for.  This is what I hope to do with my life.  This was a great day.

So, though it is so very easy to lose yourself.  Just remember, ultimately, you are the boss.  And at any moment, of any day, there is a glimpse of who you are and who you want to be, just watch for it.  Bask in it when it happens.  Then continue on with your less than satisfactory obligations until another wonderful moment appears.