Monday, May 10, 2010

Under Pressure

In general, I find myself to be a pretty darn cheerful person. I try to acknowledge the good in life more than the bad. I try to count my blessings. I try to smile. A lot.

That being said, I am not immune to the periodic funk.

Now let me be clear. I love what I do. I am thankful for the job I have each and every day. And I would never think of doing anything else. But folks, residency is hard. The hours are long, the expectations are high, and the workload is never ending. It’s easy to get run down. Most of the time, I can handle the challenge just fine. But being on night float has zapped away my reserve. It’s like my own Neverending Story, and I am Atreyu’s horse Artax, getting sucked into the Swamp of Sadness!

"Artax, please, you're letting the sadness of the swamps get to have to try!"

Like most people who gravitate towards Medicine, I have a Type A personality. I need to be good at what I do. In my student days, this wasn’t very hard to achieve. I worked hard, studied, did well. The formula was simple. Now, as a resident, the ability to perform the way I want to is a whole lot harder.

It’s no longer just about book knowledge.

It’s a juggling act of skills.

I’ve got to run a delivery room. I’ve got to coach mom during her labor while interpreting her progress while listening to the fetal heart pattern while keeping the labor nurses in the room on the same page. I’ve got to become a surgeon. I’ve got to operate quickly and gracefully and be able to get the baby out no matter where or how that baby is sitting inside the uterus and throw perfect sutures and tie perfect knots every time. I’ve got to become an effective ER physician. Out of the dozen not-really-sick patients I see every night in Triage, I’ve got to identify the one or two truly sick ones.

There is simply no room for error. And as a learner who has not quite gotten everything under my belt, this has been the most difficult part of residency. Of course, the person who is the most hard on me is me. Take last night. This was my 8th day of work in a row. I worked a 24 hour call this weekend. I’m on night float for going on three weeks. So my reserve is already low. Now objectively, I had a pretty good night. I did two vaginal deliveries (one in a most unconventional position - more on that later), I did a c-section for breech, and I saw a crap-ton of patients in Triage. Despite this evening of productivity and fun, I walked away feeling blue. I ended the night with a perineal repair that I was just not happy with. As I drove home this morning, all I could think about was this woman having an ugly looking vagina for the rest of her life – and it being all my fault.

Sigh. Here's hoping for a more cheerful post tomorrow.


  1. As a third year medical student who is planning on applying for OB/GYN, I just want to thank you for your blog. It's seriously inspiring to hear from someone who is genuinely excited about this field and yet can succumb to the pure exhaustion of the hours and expectations, but still want to go back to work in the morning (or evening).

    So anyway, wanted to say keep up the writing.

  2. thanks for the encouragement! it really is a pick me up :)

  3. I have just pulled myself out of a big funk too "Idealist"! And dont worry, her vagina was probably ugly before ;) -your co-micu intern idealist

  4. No normal human could do the job that you do, so don't be too hard on yourself. You are still a rock star!

  5. aw shucks, you guys are the rock stars! <3