Contemplating Death with New Life
Very early in the morning on Wednesday, October 18, 2023, I stumbled into the emergency department with my hair in a tangled mess and accidentally still wearing my house shoes.
Very early in the morning on Wednesday, October 18, 2023, I stumbled into the emergency department with my hair in a tangled mess and accidentally still wearing my house shoes.
I did not learn in nursing school what and who is a resident physician. It was briefly mentioned that the attending was in charge with residents below them, and that was the beginning and the end of the discussion on residents. But at the end of my first year as a new nurse on a medical floor, I could recite the names of the internal medicine doctors I spent my days and nights mostly working with — residents. By the time I left that job, I knew just a few of the attendings’ full names.
The National Health Service (NHS) is the overarching employer of medical graduates in the United Kingdom. The first two years of any new doctor’s training within the NHS is known as “foundation training” (in the United States, this would probably be equivalent to the “rotations” typically completed before obtaining an MD).
Of all the fulfilling and purposeful vocations to pursue, we’ve ended up trying to find our footing in the vast and ever-changing maze of medicine. Propelled by some combination of privilege, perseverance, and circumstance, we became doctors — many of us with the noble drive to heal and support other humans through the physical and spiritual struggles of life.
I am very pleased to welcome you all to a new academic year at the esteemed institution at which you find yourself, perhaps somewhat unexpectedly, thanks to the Match. Late June is always somewhat bittersweet, but it is a simultaneously exciting time in the academic year.
Last May, Evan matched into a fellowship that will take him across the country for a year, beginning in August. Because he’s a little bit off in the head, he chose subspecialty training that will likely entail even longer hours than residency at the same pay scale.
Two months ago, I woke up one morning at 5:30 a.m., as usual. I played my gym motivation playlist in the shower, ate oatmeal for breakfast, and headed out the door, as usual. I swore at the car that swerved into the lane in front of me without signaling, as usual. An hour later, I pre-rounded on one of my favorite patients, a man with wide, childlike eyes who had a great deal of difficulty expressing his feelings.
Overwhelmed and exhausted, a resident recently came to me to ask, “Can we do something about call?” Defeat and despair had taken over his psyche. He felt unable to cope with the tasks of residency, including the seemingly never-ending demands of fielding consults, pages and patient needs. He imagined that the problem could be solved by taking less overnight call.
The faint glow that is the light at the end of the tunnel hits my face as I realize that intern year is almost over. One would think that having been through the personal loss I have — losing two beloved older brothers at a young age — that intern year would be more than manageable. Yet this past year has been, for me, a chaotic roller coaster ride.
I never thought it could possibly happen to me. As a practicing physician with an active chemical dependency to opiates and benzodiazepines, I fell down the rabbit hole with an intensity that I never believed possible. Although I am blessed and fortunate to have climbed out of that abyss, I have never forgotten some of the things that led me to the precipice.