Hi everyone,
When I was an intern, one of my patients coded minutes after extubation. She was a woman in her 70s with dyed hair, sitting by her bed chatting with our team, when she suddenly regurgitated tube feeds, aspirated, and died. Thirty-five years later, I’m still haunted by her demise.
We’re entering the part of summer when many interns start to realize how hard it is to be a doctor. As the euphoria of graduation fades, we start facing our limits. We’re asked questions we can’t answer. To do lists loom like cliffs to scale, weighed down by phone calls, texts, and interruptions. Everyone wants a piece of us. We encounter our first deaths and complications, and then the recriminations.
I remember wondering why I chose to become a doctor and discovering I didn’t really know what I’d signed up for. I planned to save lives, learn about the body, and accept thanks from grateful patients, but I didn’t plan the exhaustion, bad outcomes, and questioning if I was doing any good.
Doctors tend to celebrate accomplishments publicly while struggling privately. Often, pride makes us hide self-doubt. Maybe it’s the image of perfection we try to cultivate, or the sunny disposition we’ve burnished to signal resilience against adversity, if we admit to facing adversity at all.
As doctors, we can’t count on fleeting triumphs to sustain us. Wins are inevitably followed by defeats and satisfaction pierced by disappointment. Like many doctors, it took me too long to realize I wasn’t the only one battling insecurity. I wasn’t the only perfectionist struggling to reconcile even minor mistakes with my image of a careful doctor.
I love being a physician but not for the same reasons I originally anticipated. Medicine constantly reminds us of how much we don’t know. I didn’t understand that good doctors don’t need to be heroes or fight disease alone. And I certainly didn’t understand that our profession requires respect for humility, acceptance of imperfection, and knowledge that we can’t succeed alone.
At Yale, we are surrounded by brilliant colleagues who all realize eventually that this is a humbling profession. It’s a privilege to practice with people who understand that doing our best is often the best we can do.
In the days ahead, if and when self-doubt enters your mind, please take a moment to open up with each other. You’ll be relieved to learn you’re in good company. I guarantee it.
Welcome to the club. It’s good to have you.
Enjoy your Sunday, everyone. We’re on the bullet train to Kyoto.
Mark
P.S. A must read by one of our former interns, Dr. Pranay Sinha: Why Doctors Commit Suicide