The vicious cycle

Somewhere along the way, I became Dr. Meanie Bikini.

No, I take that back.

I'm Dr. Meanie No Bikini. (I did gain the intern twenty after all.)

I don't know how it happened. It feels like it happened overnight. I didn't feel myself becoming meaner, more bitter, more burnt out.

I didn't see it happening. But it happened.

The abused has become the abuser.

I'm not proud of it. But I'm realizing that I'm getting frustrated at the lack of professionalism that my med students exhibit, the lack of respect they have for psychiatry, the lack of initiative that I thought every med student had ingrained into them on day one of clerkships.

I had a patient who was in florid myxedema coma, and I had to emergently transfer her somewhere - anywhere! - that could get some thyroid meds into her veins. I asked my medical student to help me get her most recent vitals for the transfer paperwork. He sighed loudly, unhappily, and then said, "Can it wait? I just need five more minutes and then I'll be done with this note." I looked at him pointedly and said, "Patient emergencies are not things that you can wait on. You came to medical school to help patients, not to write notes. And right now, the best thing you can do to help this patient is to go get her most recent vitals. The note can wait."

In case you were wondering, yes, the medical student was following this patient. And that note he was writing, was for an extremely stable, just waiting for placement, patient.

But the cherry on top? I can willingly admit that I was a bit harsh. But then he snapped right back at me. "Well, why do I have to do it? If you're transferring her, I'm not going to follow her any more, so how is this educational?"

I mean, seriously? Seriously??

To this day, he still has no idea what myxedema coma is. It might be my fault, but he had no interest in learning, no interest in knowing what qualified as a patient emergency, no interest in finding out how to triage in those kind of situations, no interest in anything but going home before 3pm.

I like teaching. I really do. But I don't know how to teach this student.