Residency, Day 1: Remembering you know how to swim

Today I started my medical residency. I’ve been out of the clinical setting for months, taking mandatory didactic courses, graduating, taking time off and moving. I was terrified as I walked into the hospital, and that terror only mounted as I worked through the morning.

I was terrified that I’d have forgotten most of what I would need to know to give my patients good care. I was terrified that I’d face heavy criticism from senior residents and attendings for not being able to do things right the first time. I was terrified that I’d offend every nurse, tech, other physician, secretary and case manager I came into contact with, and I was terrified I’d get there and be so out of my element I completely broke down.

None of those things happened.

Photo by: <<saigerow>>

Instead, today felt about like waking up in the morning after my alarm clock went off, getting out of bed and walking around rubbing my not-yet-open eyes, going through the back door and stepping right into a swimming pool.

I got to the floor, sputtered and floundered around for a bit, struggling just to keep my head above the water and nearly panicking. I had four patients I knew nothing about, wasn’t getting return pages from the intern I thought was supposed to have been on last night, was trying to learn my way around this hospital’s EMR to find the admission notes, and possibly progress notes, looking at labs and other data as I went along trying remember what normal lab values should be, and what abnormalities in each value would mean, and what other things would be on my differential for the patient about whom I was thinking, etc. I was struggling so hard to not end up in over my head, that it was hard to slow down and think. It felt like I’d sink right to the bottom if I stopped furiously thrashing about even long enough to try to figure out what I should be doing to swim, instead of just barely treading water.

Then I had a glorious moment while talking to one of my patients and answering questions she put to me. I remembered that I’d done everything I was needing to do before, as a medical student. I remembered something vitally important.

I remembered that I already knew how to swim. I still had to work hard at it, and it still wore me out, but in the end, I did my job and I think I did it well, and now I expect to find myself swimming almost every day.

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