Sunday, April 3rd, 2011
Having returned from my fourth quarter elective just days before the start of work, I had barely re-synched my Circadian clock let alone given much thought to work life proper. Maybe that was part of my adjustment process — a sort of psychological denial. “That’s Future Anna’s problem,” I often thought to myself as my Clinical Handbook collected dust during my three months in West Africa. But as D-Day grew closer and closer, there was no more denying it.
Depending on the hospital, Orientation can span a few days to a week, mine being the latter. Getting back into the routine of an 8 to 5 day was harder than I thought it would be. (Yet nothing compared to the days to come on the ward!) On our first day of Orientation we stood in line outside the Security office to get our photos taken for our ID badges. It’s quite a curious sensation, looking down at your photo and your name — the essence of the familiar – but now with the oh-so unfamiliar preceding title, Dr. Those two letters felt so obtrusive, so loud, and pretty damn scary because with it came not just free meals but, for the first time in my life, Expectations and Responsibility.
I have to admit I kept glancing at my ID badge throughout the rest of the day. Not out of narcissism but more disbelief, almost as if to check it was still me they were referring to. Doing medicine is not just a job, one we leave at the door on our way out, but something that becomes a part of our identity. A new skin we put on for life. And what makes those first few weeks of transition that much stranger is getting used to this new skin.
The night before my first day I found myself more anxious than I ever thought I would be, on a deeper level than I ever expected. I think it was the sinking realisation that there was no turning back. Sure I was excited, and I had been all throughout Trainee Intern year. But in those final hours, as I lay in bed trying to imagine the day ahead, I was 99.9% nervous. This was it.
The first day itself wasn’t that bad. Sure you feel completely out of your depth, you don’t know how the system works (unless you’ve worked at the hospital before, which I hadn’t), and you haven’t yet bonded with the fax machine so those trust issues remain, but you get through it. You get through the day, you get home – exhausted – eat, shower, get into bed, and then a few hours later you get back up for day number 2. Then sooner or later you’re driving home from day number 5 when it suddenly dawns on you that you’ve made it through your first week as a doctor. It may not have felt very doctor-ly, you may not have jumped on any chests, but you showed up and did the job they expected you to do and (hopefully) no one complained.
For a handful of you, day number 5 will not be the end of your week. Like me, you may be rostered to work your very first weekend. Again, depending on your hospital ‘working the weekend’ will mean different things. For some it may mean either a Saturday or Sunday. At my hospital, it means 12-day stretches. And with that, you find yourself wondering how you will ever get through it.
But you do.
I wish I had something more helpful to say, some tips or tricks or a piece of pragmatic advice. But I don’t. All I can say is that you will get through it.
With time, you may even start to develop your own unexpected coping mechanisms. For me it was a morning coffee, a rainbow on my shoe or a flower in my hair and, for a couple of weeks, Justin Bieber’s ‘Baby’ pulsing through my iPod en route to the ward. (Admittedly, that quickly phased itself out.) These were but little reminders to myself that the ward is not the world, and the world is not the ward; that I was still a human being and not the discharge-summary-producing-medication-charting-IV-line-inserting-emotionless-heartless machine.
Day 12, standing outside the main hospital entrance I must have been quite the vision (and not in a good way). Waiting for my ride to the airport for grad weekend in Dunedin, I was exhausted with frazzled hair, dark circles under my eyes, shoulders slumped forward, and if I’m being completely honest, probably a little smelly. Too tired to be excited, all I wanted was to drive home in the other direction and collapse into bed. It goes without saying, grad weekend was truly special and I wouldn’t have missed it for anything. But flying back home Sunday night I found myself even more exhausted yet again, a new low.
In those first few months you will have many ‘new lows.’ There will be periods of time when you might have to give up on the running or the tennis; when you find yourself eating out most nights because you’re too tired to cook; when you don’t get to make any plans with friends or family, full stop. The advice you get throughout med school lingers in your mind – keep up the exercise; eat healthy; make plans and see friends, especially those outside of medicine; have a life beyond the hospital; set goals, try new things. And on that front, for me it felt like it was yet another thing I was failing at.
Pause. Deep breath in.
But two things to remember. First of all, ‘That too will pass.’ There will be early finishes where you can make it to the gym or go for that run; there will be some weeks where your team isn’t on take constantly; and there will be a rotation where every day is an almost guaranteed 4.30pm finish. And secondly, but more importantly, sometimes showing up for work is a victory unto itself. You showed up, man. You did good. Don’t ever forget that.
