Reflect

The world is a looking glass, and gives back to every man the reflection of his own face. Frown at it and it will in turn look sourly upon you; laugh at it and with it, and it is a jolly kind companion. - William Thackeray (1811-1863)

The following are a handful of journal entries from my residency, some amusing, some serious. Writing for me is an exciting, creative means of reflection that forces me to think through daily life events in more detail.

Tomorrow in the morning marks the beginning of my year as an intern. I am not especially nervous but anxious, ready to begin, to see exactly what it is all about. The idea just does not seem real. Soon it will!

My first day as a doctor, writing orders with M.D. signifying them. Five patients I collected, three being new from yesterday. And a long day it was, rounding with the team for four hours this AM (3 interns, 15 patients). I was finished at 9:30 PM, an unusually long day, I'll say. And tomorrow at 7:30 AM, the circus begins, the pager beeping, the labs ordered, consults obtained, notes written. A merry-go-round of increasing responsibility…

Working to the end of an ICU month, a long and stressful adventure of new experience in medical management. Each patient is so different in many ways, freshly challenging the scientific, the artistic and the humanistic bases of my learning. As we conference with families to discuss dying, the moments in each individual's mind are vivid, real as revealed by facial expression, gesture and verbal comment. The perspectives are varied and as a doctor attempts to empathize, I wonder how a family accepts a new face, a stranger wrapping up decades of life in cold medical facts. Like the face of God printing a picture at the gates of death, look what has happened. And yet we tell what we would do! As if the grains of life are so similar, all is the same as the end nears, equally expressible!

Starting again on inpatient care…as role model again - how refreshing! So much different than one year ago when nervousness and self-doubt complicated daily rounds - now, relaxed, thorough and able to observe the thinking of interns and medical students, then questioning them, building understanding. We learn to think and talk artfully over a scientific foundation. And we pass our pearls on, as eager observers listen for knowledge bridged by experience.

…Not all of medicine is science of course and the art of ameliorating disease is as important. Social situations, financial hardships, psychiatric conditions require good people skills - practice in communication. And something is learned from each individual. Each day is full of revelations. What a privilege!

Wrecked the care yesterday, following the most sleepless week yet at the hospital, I deciding to nap while approaching a turning car - rear-ended, always the fault of the one behind. No one was hurt - I hit a doctor who had sympathy for me! Minor damages to the cars but circumstances which potentially are lethal… Stopping driving while sleeping is a goal.

I just answered the ringing phone to receive a solicitation from the "Illinois Firefighters Association" (I think that's the name though I could not find it in the phone book) when a person identifying himself (if only I could remember his name) began a discourse of firefighters and their contributions to society, with vivid imagery of victims to boot, and asked for a "tax-deductible" contribution. I let him know early on I was not interested but he demanded to continue, annoyed. So after his one minute of propaganda, I simply said, "I'm not interested." He said this: "I hope that next time you have a fire, the firemen are equally interested in you" and hung up!!

Residency is done! Now, my position develops into the concept of medical attending, starting tomorrow morning! Where have three years gone? I am sad to leave my position as resident. I have enjoyed the sense of family with the others in our program, as we all passed through similar trials and tribulations. Learning, doing, teaching. I begin anew tomorrow, finding the optimal ways of being an attending. Challenges! Responsibility!

"Reflections" is a collection of essays by the health professionals of the Medical College of Wisconsin.