Reflections from the conscience of a Grady Doctor: "Only a bit of turbulence"

I was speaking to one of my learner-friends today who was flying on one wing. Doctoring is hard, and learning how to be a doctor is damn hard, too. My learner-friend, like many of us do sometimes, was dealing with some self doubt. That little self-deprecating voice was getting bigger and badder, and threatening to throw life into upheaval:

Are you even cut out for this?

You aren't as smart as you think you are.

You aren't as smart as they think you are.

Everyone understands this but you.

Are you even supposed to be here?

You suck.

Been there, done that. I'm not sure if folks realize how daunting the whole medical training thing can be. I mean, it's not just the time issue. Like, a lot of people say, "How long did you have to go to school to be a doctor?" And you shrug and say, "4 years undergrad, 4 years med school, oh and another 4 years in residency. So, what? 12 years?" To which they reply with either a slow nod that implies "mad respect" for your resilience, or they simply say "damn!" which could mean all kinds of things.

What they don't usually factor in, though, is the part outside of the time commitment. The whole idea of wrapping your head around being responsible for human beings. It's not like when you forget to pay a bill and get a scary reminder in an obnoxious pink envelope. It's heavier than that. Your oops could cause someone to be hospitalized, or worse, die. So you try hard. Real hard. How many people have to worry about being an assassin on their jobs? I'm just saying--it's heavy.

When I was an intern in the NICU, I used to sit in the stairwell and cry. I had discovered which stairwell was the most deserted, and I'd leave the beeping monitors and panting ventilators to hide myself and my face in my hands. And I'd cry. Hard. Feeling sad for babies who were sick. Feeling scared that someone had trusted me with such a fragile life. Feeling conflicted about fighting to keep a baby living that may not grow to have a very good quality of life. It was one of the hardest times of my training. I'd emerge from that stairwell with my game face on, though. . . .right after shadow boxing behind the door. You can do this, I'd tell myself. You can do this. Sometimes I believed it. Many times I wasn't so sure.

So, I guess that sums up what I told my learner-friend. In fact, here is part of exactly what I said:

"alas, there's nothing new under the sun. we're all flying on one wing sometimes or even in a tailspin but doing our best to speak confidently into the microphone saying, "folks, please keep your seat belts fastened, this is only a bit of turbulence" (knowing full well that it is waaaay more than turbulence.) the key is to right the plane. . . .and to keep speaking confidently to yourself until you perceive everything as just that -- "only a bit of turbulence." "


Now that I've been at this longer, I've learned to combat those occasionally negative thoughts that creep up with positive ones. And the more time that goes by, the better I get at amping myself up with atta-girls. I can't say I was this good at cheering for me when I was at my learner-friend's level in medical training--this kind of coaching of yourself takes time. Here is one of my favorite auto-responses to the negative internal commentary that faces nearly all (truly introspective) doctors and doctors-in-training:

You suck.

No! You inspire.
And you can do this.
And you're supposed to be doing this.

Now I do believe it. And I hope someday my learner-friend does, too. The bumps? Aaaaaah. . . . . just a bit of turbulence. . . . .prepare for landing, my friend. . . . . . prepare for landing. . . . .