Final year of med school has just hit me. There is a subtle shift – knowledge and facts coalescing, light dawning. I still feel like I know nothing, but every so often I feel like I know what I’m doing and why I’m doing it.
Another subtle shift is underway on the hospital floor. Next year I could be a colleague. People ask where I’m applying, offer advice, discuss cases of interest like my thoughts could matter.
I decided about ten days back that I needed to stop avoiding the things that freak me out – practical procedures. And Whammo! No sooner had I decided this than a flurry of practical procedures came my way. Under supervision, I drained 2.4L of fluid from an elderly lady’s chest (“I can breathe again!”), and did not generate a pneumothorax. I sutured (extremely badly). I backslabbed a man’s fractured wrist and completely failed to get a cannula into a vein for a man who desperately needed one. Two in fact.
Today I assessed a patient in ED, summarised my findings, proposed a diagnosis, recommended therapy, and discharged them home with scripts and instructions.
I second-guess myself.
“What if it was amyloidosis?”
“What if I sutured his skin all wrong?”
“What if he’d got fluids earlier?”
“What if I introduced an infection?”
What if I never made a mistake and never learned anything?