TRANSITIONS IN PRACTICE
( continued from page 11 ) apparently grew bored with my initial attempt and left to
talk to another doctor
• Discovered a world of difference in answering multiple choice questions versus open-ended questions on the spot while others look on expectantly
Early on , I asked my attending about my first patient , “ What can we do for him ?” In a sobering moment , the attending explained that there wasn ’ t much we could do for him outside of regular dialysis and palliative care . I remember going home later that day feeling disturbed by the notion that Mr . D was dying . I wasn ’ t naïve enough to believe medicine infallible , nor did I believe doctors capable of prescribing a panacea for every ailment , but this was my patient , and it was disheartening and humbling to face this reality . While Mr . D would be under my team ’ s care for his time in the hospital , there would be little that we could do to improve his health .
Regardless , I tried to spend quality time with him that first week , determined to establish rapport and a quality relationship . But throughout the week , I felt discouraged . Talking to his nurse later in the week , she remarked , “ He ’ s so nasty and mean ,” before looking at me expectantly . I paused , unsure of what to say . He was certainly grumpy and hadn ’ t so much as chuckled at one of my jokes , but should that have any bearing on the care we provide ? The way we negatively perceive patients should ideally be addressed with proper empathy and awareness of our implicit biases .
Among other things , clerkships are a balancing act – impress your mentors , but don ’ t suck-up . Show up early and leave late but find time to study for your shelf exams . Ask questions , but don ’ t be overbearing . Answer questions , but don ’ t overshadow your peers and don ’ t be a know-it-all . Be independent but know how to ask for help . And sleep as much as possible in between . Third-year is also a time of increased responsibility . Early on in my first rotation , I remember feeling waves of imposter syndrome as the attending asked me for my thoughts on what to do for a patient .
I thought to myself in surprise , “ Me ?”
Even more surprising was when the attending agreed with my plan . She didn ’ t always agree with my plan but as I quickly discovered , that ’ s the best way to learn . With that expectation , it was easy to become invested in my patients ’ well-being and learn the team ’ s plan to manage their care , along with all the little nuances that can affect decision-making .
Later in the rotation , I was speaking to a classmate about my first patient Mr . D . She made a similar comment about how he didn ’ t seem to like anyone . “ But ,” she clarified , “ he really likes you . He said you ’ ll make a fine doctor someday .”
In a week full of growing pains and misgivings , such a small comment meant a surprisingly great deal . It spoke to some level of connection I had formed with the patient and also reminded me there ’ s always more to providing care than just a diagnosis and treatment .
There will inevitably be moments in the coming years as I graduate and move on to residency , when I stumble and falter . But I want to take it all in stride and recognize I will only grow more comfortable in this strange field of medicine that is so full of complexity , humility , frustration and deep gratification , and hopefully learn a thing or two along the way .
Nicholas Chen is a third-year medical student at the University of Louisville School of Medicine .
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12 LOUISVILLE MEDICINE