03/08/2021

It’s another Wednesday on my family med rotation and the attending and I walk into the room of one of the last patients of the day. As soon as we enter, a strong, unpleasant smell felt like it punched me in the face. Throughout my third year rotations I have been getting accustomed to the various smells of patient rooms, especially inpatient, but this smell was different, I almost felt disgusted. However, once the attending was going in depth with interviewing the patient, I realized he was actually being quite rude to her. I completely forgot about the smell at that point and immediately felt compassion for the patient. She is of Asian origin, and English was her second language. I was able to understand her well but the attending was having problems unraveling what she was saying. This was not the first time he had trouble hearing his patients well but he had never been this confrontational about it before. He said things like, “you’re making this really difficult” and sighing in exasperation.

On the other end, the patient herself seemed to have a little hard time understanding what the attending was saying. I could understand what both of them were saying but was afraid of intervening since it seemed like the conversation was heating up a bit and I was unsure on how to diffuse it. The patient did admit to being slightly hard of hearing so this whole scenario was an accumulation of communication issues. Before I left the room at the end of the appointment, I imparted some compassionate words so she would not leave feeling completely disheartened.

Outside the patient room, the attending expressed his frustration and I told him it seemed like a cultural difference but he vehemently denied that and repeated it was a hearing issue. I did not bother continuing the conversation and instead just followed him into the next patient’s room.

Through my third year, I have seen great acts of compassion while at other times I have seen quite the opposite. I aspire to be the kind of physician that remembers her humanity and continues to provide compassionate care. I think part of the reason physicians and other healthcare providers lose that part of patient care is by getting jaded. I’ve seen numerous jaded residents but have not seen as many jaded attendings. Moving forward, I will ask attendings what the secret is to maintaining humanistic patient care. This will help me keep that in mind during residency and beyond so I can provide better care.

Further, I realized how my own biases can appear. I’m not sure if bias is the correct word, but it did change how I viewed the patient at first. The smell was so overpowering, I could not even pay attention to the patient interview at first. I was surprised at how I felt, but now that I realized how my bias feels, I can change how I react to it. This will also help me with providing the best care possible.

08/06/2021

Over the summer I have had the opportunity of working with exceedingly compassionate physicians and seeking their insights on how to continuously provide humanistic care. They commented on treating patients in the same way that they themselves would want to be treated if the roles were reversed. Moreover, each had stories on witnessing intentional or un-intentional callous acts of other physicians prompting them to act the opposite. Hopefully, I can continue to be cognizant of this as I progress through my training. I believe continuing regularly scheduled (bi monthly?) reflections such as this will help hold me accountable.

12/11/2020

It’s halfway through third year and I still want to do surgery but I wish I wanted to do something else. Currently, I am on the HPB service and it has been brutal sleep wise. I prided myself the first two years of med school in sleeping 8 hours but that is no longer possible. I found myself sleeping much less since starting HPB and felt physically ill by it. I heard people get used to it but seeing the under eye circles deepening makes me sad. I feel like I have to sacrifice my most basic human needs (eating, sleeping, etc.) in order to become a surgeon and I am not sure if I am ready to do that.

However, residency is temporary but 5+ years is still a long time to be miserable. I think doing more surgery rotations during 4th year will help me decide if I am best fit for that lifestyle. Regardless of these struggles, I felt like I have grown the most throughout my surgery rotations. I’ve been pushed to my limits physically, mentally, and have gotten used to being uncomfortable. I feel like everyday has new learning opportunities and I have had multiple chances to pursue my goal of being more assertive with my education and speaking up. I still feel anxious at some points doing so but with repetition it has abated.

I’ve heard from residents that that feeling of being uncomfortable doesn’t go away. If anything, it’s amplified during residency. So, I am kind of grateful that I get to experience this now so I know how to handle it during residency. I have begun more to stop caring so much about what other people think of me and being more myself. It has been a freeing feeling especially now when I feel like I don’t get much freedom. I come home after a long day, try to be productive, go to bed, wake up and think what would happen if I slept in late, get ready and go back to the hospital. Some days I just want this to be over, other days I am amazed by what I see at the hospital. What I get to see is incredible; it’s a privilege. It reminds me of why I decided to become a doctor in the first place. I think these moments are important, they help drive me to finish what I started. [okay to put in non surgery example?]

Overall, I would have to say my surgery ring has been the most challenging but I have enjoyed it for the most part. It has been a love-hate relationship, mostly love. I’ll end with an anecdote involving my significant other. It was the night before Thanksgiving, after another long day at the hospital, and my mentor, a congenital cardiac surgeon, was telling me how he was at OSU for a transplant case and was wondering if medical students were still privy to clinical education. My significant other and I had already made plans to drive to his family’s for the holiday but I told him if we hadn’t already made plans, I would have joined my mentor in a heartbeat (pun intended). I said, “I don’t care how tired I am.” In that moment, I knew that deep down my decision on a specialty had been made. I am just in denial consciously. This ring has pushed me to be the person I always imagined myself being as a physician, assertive, confident, and knowledgeable.

Below, I’ve included two screenshots of previous CPAs. One is from how I began and the other is how I desire to be. My goal is to continue this trajectory of growth of being more outspoken.

08/06/2021

8 months later, I am still tired but I am happy with the specialty decision I made. After spending time in the SICU and on cardiac surgery rotations, I continued to grow into the surgeon that I aspire to be: confident. I often get feedback stating that I am knowledgeable and just need to have confidence in what I am saying. Now as a fourth year, I don’t get feedback that I am quiet or to talk more. There is always something to work on but I feel accomplished after finally getting a handle on this specific trait.