Facing the Firing Squad

Yesterday was one of the worst days I've had in medical school so far. The week leading up to it was extremely stressful, packed with tutorials, studying, electives, shadowing experiences and other major time commitments. I found myself leaving the house every day at the crack of dawn and returning by 9 or 10 at night, grabbing a quick bite to eat before starting tutorial review. And then I would get a few restless hours of sleep before dragging myself out of bed to start another day. For whatever reason, all my major commitments happened to coincide to create the week from hell. 

On Monday night, I finally collapsed into bed at 2 am and decided to take a sleeping pill to ensure I got a good night's sleep for my clinical training the following morning. I rarely use such pills, and so it came as a shock when it totally zonked me out. I was asleep within minutes. It took every ounce of motivation to drag myself to the hospital. Our task was to do a basic interview with a “standardized patient”, or in other words, an actor hired by the university who pretends to be a patient. All the students (nine in total) sit in a group with the two supervisors and critique one another's performance. It's a little intimidating to be doing a mock interview as eleven people watch your every move (albeit, very nice people).

I happened to be the last to go. After three hours, I think everyone was a little bit impatient for the session to be over. My “patient" presented with severe exhaustion, but I'm pretty sure I was more exhausted than she was. I started doing a basic history, asking about when the problem started, what was happening at the time, what she had tried for relief, etc. etc. I had trouble concentrating and my interview seemed to veer way off track. I hadn't even gotten on to recommended treatments by the time the timer rang, abruptly ending the interview.

I looked to my left, at the assembly of nine students and two preceptors, all looking thoroughly unimpressed. Oh crap. The students had been instructed to be honest and critical in their feedback; after all, how else would you improve? Judging by how much I had just bungled up the interview, I felt like I was facing a firing squad.

Let's just say, I took a battering - a polite, Canadian-style battering - and it was totally deserved.

Right after class, my fever returned with a vengeance, and I had to drag myself through the rest of the day. It was exhausting and demoralizing.

Now I'm sitting at my laptop with a hot cup of tea, recovered and rested. I think the most important lesson I've learned from this experience is that, in order to be a good care provider, I really need to take better care of myself. A burned out individual exudes a negative energy that turns people off and may make patients less willing to open up about their problems. When I'm very stressed, I find it harder to feel and show empathy, and is that really fair for the patients? Sure, I can still do a good history and physical exam, but medicine should be about more than just checking the boxes.

So I'm putting myself on a regular sleep and exercise schedule, cutting down on unnecessary commitments and finding time to decompress every day. With any luck, this exhausted, burnt-out Raman will be replaced by a rosy-cheeked, smiling Raman within a couple days. And then I can hit the next interview out of the park and redeem myself. Fingers crossed.