- Making a provisional diagnosis of an exacerbation of pneumonia in an elderly patient and finding out through investigations that she's actually got heart failure (how did I miss that?!)
- Cannulating an elderly patient with really tiny veins and getting it -- And then missing it (what a difference a second makes...)
- Ending a shift in ED feeling like you really haven't got much right today
Don't get me wrong, I am loving my Emergency rotation.
But if there's one thing that I've realised more and more since starting my final year, it's that being a medical student comes with an expiry on your level of usefulness.
When the Emergency Department is bustling with acute incidents and there's so much to be done, at the end of the day, the nurses work faster than you do, so you just end up being in the way.
While the doctors are busy doing doctor-things and you've done your medical-student-things, you need to get things signed off by a "real doctor", guess what? They're occupied.
So you just wait til they've got a free milisecond to sign off that pathology form for the blood you've just taken or the investigations that you've written out to be ordered, and until then, you've hit a brick wall in terms of productivity.
I certainly won't be missing those limits when I'm a fully qualified doctor. I'm looking forward to being able to sign for things in my own right and follow through with the workup of my patients. In short, I'm looking forward to having more control.
However, I am aware that more control comes with more responsibility and as much as I am eager for it, I don't know if I'm good enough just yet.
I know I've got to work hard to be better, faster, sharper... But it's hard work. It's like climbing a mountain and having rocks fall on you as you struggle to get higher. At the end of the day, you just feel extremely battered, but not much better for it.
You might recall that a couple of weeks ago, my friend Keira took me to see a performance at the National Institute of Circus Arts. Inspired by the show, I signed up for a beginner's course in aerial acrobatics.
I expected my first class to be an introductory session, but instead, the first thing we were asked to do was monouvers on a static trapeze. Sure, they were basic moves, but having never seen a trapeze up close before, actually getting on it was an incredible feat itself without taking into consideration that I actually had to move on it! And trust me, the static trapeze was the easy part of the night.
Needless to day, it was a brutal session. By the end of the hour, my muscles burned and I could barely walk straight. I came out of my first class last night with the stark realisation that my body and my will were truly weak. After all, my teachers and classmates made it look so easy! And if their expectations of me were anything to go by, it really should not have been that hard.
They climbed and curled and defied gravity like it was second nature to them. It was beautiful to watch, whereas my efforts would probably have seemed less dainty and more ghastly. Contrary to them, I was weighed down by my lack of strength, coordination, and confidence. I felt the limits.
The parting words of one of my teachers (whom, by the way, I fell on top of during one of my attempts to climb the rope) were this: "Don't give up... You can do this. You have the strength, you just haven't figured out how to use it yet."
They say that the key to gaining competence is to just keep at it. But what do you do when you're just plain tired?
What do you do when your muscles ache and your mind has turned to mush and you just cannot squeeze even an atom's worth of effort any longer? What do you do when you're just not good enough?
Trying to be better is a simple concept to grasp, but the actual feat is far from easy.
And, in my opinion, despite loving the climb, being at the foot of the mountain and knowing that you have such a long way to go is not much fun.
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