“What part of what I just said did you not understand?”
The fellow patronizingly chastised me in front of the entire medical team. Her tone and body language felt demeaning, almost as if she was more intent on embarrassing me than caring for the patient. I left this interaction, like most others with this fellow, feeling inept as a senior resident and as a care provider for my patient. In lieu of the hundreds of tasks I needed to complete before the morning sun, I instead spent time second-guessing my own ability.
As things settled down for the night and the babies finally fell to sleep, I reflected on the emotions running through me: a combination of frustration at the learning environment we are subjected to and disappointment at my own abilities. As a former middle school teacher, I knew of Maslow’s hierarchy of needs and that, in order for students to learn, their most basic needs must first be met, like eating and sleeping. Residency can deprive doctors in training of both these elements, and yet the expectation remains that when we finish, we be well equipped to care for our patients. From shifts that can last 30 straight hours, to regularly missed meals, we are already at a disadvantage to quality learning. Any additional stressors, such as verbal abuse or condescension, can make the task of attaining new knowledge and skills nearly impossible.
Further, even as accomplished students, having completed and excelled at a minimum of four years of undergraduate studies and four years of the rigors of medical school, we can be made to feel as though we know nothing. This creates a working environment where speaking to colleagues disrespectfully is allowed, and in some cases, expected. As new trainees become more senior, the vicious cycle continues. I always wonder, do people use the same tone and language to talk to individuals outside of the hospital? Do they think that people in all professions treat each other in a similar fashion?
As self-doubt and frustration started to overwhelm me that night, I took a few deep breaths and tried to focus on the reason I pursued a career in medicine: to care for the most vulnerable of all patients: children. Shortly thereafter, I decided to take a walk and came across a nurse preparing a bottle to feed a newly admitted patient. I asked her if I could assist in feeding, and she was pleasantly surprised. It is rare for physicians to take part in this task, and it was new to me as well. Still, at that moment, I felt compelled to help. In fact, I needed to help, for my own sake. For the next ten minutes, my pager is silent, my phone does not ring, and with baby and bottle in hand, I forget about the negative interactions of the night and was reminded of why I chose pediatrics.
I am sure that all residents have experienced interactions similar to or worse than mine that evening. While it is completely within our nature to get frustrated, what is even more important is that we are able to continue our role as compassionate physicians. For me it was a baby to feed, but for you the solution may be entirely different.
There is a saying in education that goes: “To the world you may be just a teacher, but to your students, you are their world.” As a former teacher, this quote motivated me through the good and bad days of the school year and the same principles apply to us as physicians. While the seven year old with an asthma exacerbation may be one of 40 patients you are caring for that day, to them, you are the gatekeeper between sickness and health. Never forget the power and influence we have on the course of a patient’s life, and use that responsibility to do whatever it takes to care for your patient. Find what you need to be able to keep treating your patients with love.
Find your baby to feed.