Friday, 12 May 2017

Within Doors

First week of internal was... probably my worst week of clerkship so far.

Well, there's no 'probably' about it.

Basically, my anxiety got the best of me and I froze up at every possible opportunity to demonstrate any sort of skill. I stammered a lot. My presentations were awful.

I just, overall, completely sucked as a clerk and basically made more work for everyone.

The way the CTU schedule is, we really have about 3-5 hours a day of clinical time. The rest is spent in teaching or meeting with our team (new patient rounds in the morning, running the list throughout the day, or handover.)

I lose about an hour of that because I need to pump. My pumping room (a call room) is in the juniors residence which is on the first floor in a different wing, far away from where I'm usually working. I'm down to two pumping sessions a day, but still, adding in time to get there and back, plus pumping time, plus time to wash my stuff, and I lose over an hour of that clinical time, and I can't run off during other activities.

So between my absurd level of sleep deprivation, my sky-high anxiety about doing poorly on this rotation, and the fact that the issue I've been trying to see my doctor for since February is getting worse, I'm basically a stressball at the moment. I'm that harried, slightly crazed-looking med student who is muttering to herself and stumbling over words while presenting.

In short, an absolute mess.

This is burnout. I'm actually a very strong student with a very solid knowledgebase. There is absolutely no reason my reflex should be to say "I don't know" about things I'm 95% sure of, but I still do that because my anxiety gets the best of me.

I'm also in too much pain to bother putting in the effort some days. Looking up the ridiculous name of an obscure trial so that I know the answer to some trivia question the next morning is really not high on my priority list. Absolutely I need to keep up on medical research and I need to be critical of evidence and stay on top of guidelines and why they are the way they are... but that's supplementary to, not in place of, what I need to work on right now. Preclerkship helped me build the foundations of my medical knowledge. Clerkship is building the walls. Residency is deciding on all the fiddly bits and doing the decorating.

I'm coming out of my first week of internal feeling very defeated and exceedingly stupid. No one was unkind to me at all; in fact all the staff and other learners have been very kind so far.

The very last day of my program is less than a year away, and honestly I've never felt less prepared than I do today.

Logically I know this feeling will pass. I know I will get through this, I will learn, and I will be fine because I always am and I tend to 'anxious' myself into a far bigger mess than I have any right to be.

But anxiety isn't logical, so despite logically understanding that like all things, this too shall pass, it's still hard until it does.

I'll get there. Just not soon enough.

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