There are some days when I'm absolutely great at what I do. I can take a history like nobody's business. Got a heart murmur? I'll hear it. Took some ilicit drugs last night? I'll know. Can't speak English? I'll translate. (Or find someone who can.) I'll gain a patient's trust with just a ten minute interview. I can churn out those H&Ps and get pharmacists and social workers to help my patients with a simple phone call, my charm on full blast.
Those are the good days. The football-kicking days.
And then there are the other days when I feel as though there must have been some kind of fluke in the admissions system, because there's no way someone like me - someone as dumb as dirt - could possibly have been admitted to this school.
I feel it when I get asked stupid "pimp" questions, where it's one of those either you know it or you don't situations, and you swear you knew the answer three months ago, but right now, on the spot, it's eluding you - the name of that syndrome that presents with watery diarrhea, hypokalemia, hypochlorhydria, and metabolic acidosis. (It's Verner-Morrison Syndrome, by the way. Also known as VIPoma, but apparently that answer isn't detailed enough for some attendings.)
I feel it when I present my oral presentations, and I'm asked pointed questions that ultimately make me realize that my diagnosis was all wrong. Or that it's fairly obvious to everyone else that I should have known to check for a folate and B12 level.
I feel it when I miss stupid study questions, and I internally yell at myself. "UGH! I KNEW THAT. WHY DID I PICK THE OTHER ANSWER? STUPID STUPID STUPID!"
Medicine. I hate it, but I love it. Even though it brings me down more often than not. Much more often than not.
And so, on those bad days, I yell and cry and rage against the machine, and the next day, I pick myself up to start all over again. Because I have to believe that I'm going to be able to kick that football. Maybe not today, but maybe tomorrow. Or the day after that. Or even the day after that. Gotta just keep running after that football.
AAUGH indeed, Charlie Brown.
