Medical students just might have a superhero complex.
After all, for the most part, we all came to med school to save lives. We want to care for patients and make them feel better. Lessen pain. Even those who came for the fast cars and the easy money snapped to reality very quickly and either left or realized that they actually do want to help people.
And so we start school bright-eyed and excited. Hungry to be getting out there to make an impact in the world. I mean, most students can tell you everything about their first patient. First and last name, age, date of birth, what they presented with in the ER, the complete differential, and possibly even how many dogs and cats they have. It's because we're hungry to help, hungry to finally be able to touch someone's life. And so that first patient is super special, because it's validating. This is, after all, why we came to medical school. To care for patients.
What they don’t tell you is how absolutely and completely scared they are.
Yes, I remember the very first patient I saw. He had a foot infection secondary to lower extremity neuropathy, was fifty-seven years old, and a successful interior designer. And he has three cats named Fluffy, Mops, and Piglet.
I could rattle off his differential diagnosis (there were really only two possibilities), and impressed my preceptor with my detailed assessment and plan. We should start him on antibiotics and antifungals – perhaps a cephalosporin and nystatin? Oh, and let’s order a CBC to make sure his white blood count is okay so he can fight off this infection.
I might have sounded confident, but in reality, I was shaking in my Crocs when I walked in the door. After wanting to come to medical school for all the right reasons, I was now convinced that somehow or another I might accidentally kill the patient. What if I tripped over his IV line? What if he coded? I had no idea how to do anything, much less save a life. I was terrified - irrationally so, considering I was merely going to ask him a couple of questions, and while my mother always complained of it, I don’t think I could actually talk someone to death.
As medical students, we are obsessed with death. Our Type A personalities might have drawn us to medicine, but that same personality is what makes us equate death with failure. Yet, death is a very tangible thing in medicine. Medicine is a profession that constantly straddles the line between life and death, and the relationship between the two is pervasive and ever-present. A simple mistake or a wrong decision can have devastating results.
I am just starting to realize the amount of medical knowledge that exists out there, and how little I know of it. I am starting to realize that no matter how hard I try, I will inevitably kill someone. Sure, it’ll be accidental, due to an oversight, maybe because of a lack of knowledge. But I also know that I will be devastated. I will be devastated, because causing harm to a patient is to go against the very thing I came to medical school for.
But I will learn from it. Apologize to the family. Face the consequences. Figure out what went wrong, how it went wrong, and then move on. Patient deaths are part of the learning process, and in medicine, physicians are the perpetual student. We can never stop learning - not just because our field is ever-evolving, but also because that is what will ensure that we are the best possible physicians we can be.
In the end, I know what will carry me through such an experience is the fact that I am a good doctor. I’ve been trained well. In all the stories I’ve read about medical mistakes, there was always a very specific point where the doctor made a poor judgment call. A bad decision. But we are all human, which means we’re prone to make mistakes. We don’t have any control over that. What we do have control over is our relationships with our patients. How we treat them as patients – as people – will make a huge difference in their medical treatment. That is what will help us make the right judgment call. The right choice.
It's about having heart. And at the end of the day, I know that I have a good one. I care. That is ultimately what will make me a good doctor. And even good doctors can make mistakes.
3 years ago
