On Becoming a Physician

It is hard to imagine that someone can emerge from intern year – 12 months of chaos, little sleep, and hours upon hours spent responding to pages and putting orders in a computer – and know something, anything, about medicine. I did not believe in this training system until now, after my first night as a supervising resident. The knowledge I have absorbed over the past year is finally flowing, smooth as water, and I continue to surprise myself.

I recently had to go back over the last year and place a final signature on all the documents I created  – in three months that I spent working in the medical and intensive care units, I wrote over 300 patient notes. Over the course of the last twelve months, I have seen thousands of patients walk through the doors of this hospital. I have diagnosed, cared for, saved, and lost lives – too many to count. I have watched a new mother hold her child for the first time. I have stood by families whose children are dying under my care. I have watched patients my own age struggle to survive. I have cared for friends of friends, people whom I knew long ago in a different context. I have watched the world through the eyes of this hospital – every heartbeat, every breath, every minute.

And this hospital, in a very strange way, has begun to feel like home. I have spent so many sleepless nights here. I have cried behind its closed doors. I have watched rain, snow, and sun through its windows. I have spent time in so many hidden corners of this building – and I would like to hope that, when I have completed my years here, I will have left a trail behind me of a small spirit, a small presence, for my patients.

As I retrace my paths in this place time and time again, I realize – only in retrospect – that, without my realizing it, my steps have become more certain. Somewhere along the way, I stopped being afraid of the hospital. And somewhere along the way, I stopped being afraid that I was not capable of becoming a physician.

Last night, as I watched my intern in his attempt to draw an arterial blood gas, I guided him only with my voice. “Increase your angle, move to the left, increase your angle more, withdraw slowly. Keep it still.” And I guided him with ease until he was right in the vessel – blood filled the syringe. Success. Not by chance. He looked up at me, surprised at his success, as if to say, “How did you…?”

But he will not know the answer to this question until much later. The answer lies in the hours upon hours that I have labored to place lines on sick patients. The answer lies in the countless nights I have spent at my patients’ bedside, knowing that the nurses and my patients are relying on me. The answer lies in the life of the intern – giving up everything to prove to everyone else – and to yourself – that you are a doctor.

When no one in the intensive care unit can get an IV line on a patient, I use the ultrasound to find a vein and place one. When anxious nurses and interns struggle as a patient codes, I am the one who establishes calm. When a patient is sick, I am the first to come to the bedside – no longer as a haggard intern, but as a doctor who wants to make my patient better.

This did not come easy. And it did not come without a price. But, having come out on the other side, it makes me realize that there is some good we can do in medicine, in spite of all its flaws. There is something special that we can offer if we act as compassionate physicians. And the reward – gratitude from patients and their families – is humbling. It restores some of my faith in humanity – that we can all appreciate one another, work together to care for one another, and help to make the rough spots in life a little less lonely, a little more bearable.


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