24 January 2011

We all fall down

Well, I suspected it would happen, but surgery broke me. On Friday night I was reduce to tears. Or more accurately, collapsed sobbing on my bedroom floor. It was, in all honesty, a pathetic sight and a definite low-point. How did this happen? Well... Friday actually started out quite well. Rounds went relatively smoothly since we had the relaxed fellow. Then it was off to clinic with the nice attending. The first two patients didn't show so I was able to grab a coffee and tend to some email. I managed to see six patients and write their notes before leaving for seminar, prompting Dr. E to tell me I was "ready to be a fourth year." So yeah, the day started out fairly well. Seminar should have been a hint. It was about our future, a topic that always give me a little spasm of fear: will I be able to match to geography I like given my Step 1 score? Am I going to get stuck doing primary care in Idaho? A classmate approached me during seminar to tell me that the uptight fellow had scrubbed on some cases at the VA with him and spent the time in the OR asking my fellow student pointed questions about ME (unprofessional!). He couldn't say anything nice (what?) so he lied and said he had never been on service with me (thanks). I got back to the conference room after seminar in time for afternoon rounds. When the other students on vascular got back they made it clear I shouldn't have left without them (they left without me last week). Off to teaching rounds with the over-enthusiastic attending who pimped JUST ME on surgical abdomens, but felt the need to stop halfway through to tell the whole room that I was defensive and arrogant and should get that under control (unprofessional!). After teaching rounds the two medical students on vascular cornered me to have a frank talk about how I interrupt too much. I then took some staples out of a woman's abdominal wound and was allowed to leave. I got out of the hospital into the freezing air and tears started sprouting. Trouble is, they started freezing in my eyelashes as I walked. Yes, I froze my eyes shut crying on the walk home.

So let's reflect: yes, the "constructive" criticism I received is grounded in truth. My board scores are my fault. I am defensive, but not out of arrogance. I hate getting things wrong because I'm terrified. I probably do interrupt too much, but could that conversation possibly have waited until the next day given they had just watched me get humiliated by an attending? Not to mention that I have not committed the cardinal sins of throwing another student under the bus or claiming all the good surgeries?

End result: I don't have skin thick enough to be a surgeon. Nor do I want to. I do take it personally when people criticize me; because I care. I care that I'm good at this and that I am respected. I don't want to become the kind of person who can humiliate another person in public just because they can't talk back for fear of their grade. It does not help my learning. Being a good teacher is about motivating and empowering, not belittling and intimidating. Surgeons seem to confuse fear with respect.

No comments: