How Am I Going to Learn Enough?!

I am so frustrated right now. I've spent the past few days reading about ventilator management, lung volumes, and acute respiratory distress syndrome. We've covered congestive heart failure and why the traditional way of thinking about acid-base disorders is incomplete. However, for some reason I just can't get questions right when people ask me point blank. For instance, even though I read an article my preceptor suggested a few days ago, I just couldn't summarize it when he asked me to this morning. What has happened to my recall? In high school, that wouldn't have been a problem. In fact, I think memorizing medicine in general would have been easier in high school.

I'm quite sure the British system does have something over us -- they take kids right out of high school and teach them, so they still have the ability to stay up all night and study, or memorize things as soon as they read them. I don't know if my brain is aging or rusty, but it's just maddening to know that you can't recall something that you thought you knew. Today, at the end of the day, a neurologist was quizzing me about locations of strokes in the brain. I *knew* this stuff at the end of last year -- and now it's gone -- poof -- like the wind. F*%K. A great way to end the day, looking like an idiot in front of your senior resident. Terrific. I'm being quizzed about everything except the lung on this pulmonary rotation.

And here's the twenty-four million dollar question: If I don't have this stuff memorized now, when on earth am I going to have a chance to learn it? How am I ever going to become the type of doctor I want to be -- the kind that understands physiology, biochemistry, and disease? How many times a day can I feel like a complete idiot? When will I know how to manage patients on my own? What the hell is wrong with me? Seriously, just shoot me now.

The child upstairs is singing 'Colors of the Wind.' The most relevant line from that song:

You'll learn things you never knew you never knew.

It's clearly a song about med school.

Anyway, there has been another milestone in the process of becoming a doctor: I have my basic lifesaving skills card, and I actually performed my first real CPR during a Code Blue in the ICU on Friday. It's physically more demanding than I realized. He was in shock, of a type that has a very high mortality, so the prognosis was unfortunately grim from the start. Then I had to call the family to let them know that the patient had passed away. I was grateful that my resident trusted me to make the phone call myself.

You know, what they don't tell you about medicine is that it's not the long hours, the terrible things that happen, or the yuck factor that makes it difficult. For me, the long hours are fine as long as I have enough food; the patients are the brightest part of my day, even if things are taking a turn for the worse, because you can't just abandon people if things go to pot; and the yuck factor is negligent because I was fortunately given a strong stomach. It's the doctors. The residents sometimes, and the senior doctors often. Some of them have a gift for teaching students, but most do not. They personally resent the extra work teaching requires, no matter that they chose to remain in academics. A few seem to particularly enjoy humiliating medical students, especially if there's an audience or a competitive aspect involved (like grades).  I guess it does make them look smarter, but how are they going to feel when one of those junior doctors is the one taking care of them when they grow old? The Hippocratic oath involves promising to teach the next generation of doctors as though they are your own lineage, not as though you are shooting fish in a barrel, and I hope I remember that if/when I get to that stage in my career. Hazing went out with the baby boomers.

For this reason, I am dreading my presentation tomorrow. What should be an opportunity to present and learn something will instead become a who-can-take-turns-outshining-the-dumb-med-student session. Am I the only one surprised that many doctors are, to put it mildly, not very nice people?

Okay, done venting. Mom and Dad, it's still worth it. Make change from the inside, and all that.