posted on: Wednesday, March 13, 2013

intern year. circa May 2012

i started working in the Burn ICU last Friday at 6am.  i had just left the hospital at midnight the night before, after finishing up an ER shift.  in hindsight, i probably should have just slept in a call room.
but i wanted to sleep next to my hubby.

needless to say, things were a bit of a blur that first day.  i didn't know the rules.  i wore the wrong scrubs. and they videotaped rounds as part of a research study.  sleep-deprived and frazzled on tape...it wasn't pretty.

Sunday i was on call.  i got to the hospital at 6am, rounded with the team, then everyone left around 11am.  and i was by myself until 6am the next morning.  but didn't leave the hospital until noon.

i was so tired.  and the patients were just so sick.  it's incredibly overwhelming.  i think this is something i'll have more collected thoughts about once i'm through it?  but for now, i've been thinking about how doctors make mistakes.  i definitely made a few during that 30-hour call.  some of them had bad consequences.  to say i'm torn up about it would be an understatement.

i know that i'm human.  but sometimes i think my patients forget that.  doctors aren't allowed to make mistakes.  the general public has precious little tolerance for the fallibility of doctors.  and while i appreciate being held to a high standard, the pressure gets a little too intense sometimes.

last year, during my intern year, i had high hopes that i would learn everything i needed to know to provide the best emergency care anyone could ask for.  as i neared the end of last year, the panic set in, as i realized that i would never be able to learn it all in three years.  "that's why they call it the practice of medicine" said my mentors.  you never stop learning. never perfect it.

but something changed between last year and this year.  last year, i was "just an intern".  if i screwed up, it was okay. expected, even.  if i nailed a procedure or diagnosis, it was a party.  confetti was thrown.  there were pats on the back.  parades in my honor. 

this year, i'm expected to know what i'm doing.  there are no parties thrown if i get it right.  just a "good job".  because that's what i'm supposed to do.  get it right.  now i'm the one trusted with caring for these incredibly sick burned patients all night long.  i'm the only doctor in the hospital taking care of them overnight.  if i can't hack it, i've got at least a 20 minute wait until another doctor drives in from home.  it's scary as hell, i'll tell you.  and there literally isn't a minute of time that goes by during that on-call period where my heart isn't pounding and i'm telling myself there's no way i can do this.

medicine is a profession where you get promoted before they're sure you're capable of doing the job.  when you finish intern year, you're awesome at being an intern.  that's why they let you pass.  but you know nothing about being a second year.  that's something you learn on the fly.  you go from being very closely supervised to doing things 100% on your own.  it's a hell of a jump to make.

and we make mistakes in the process.  i make mistakes in the process.  and i have to look family members in the face and tell them "i did this."  there's no glory in that.  it's not glamorous.  it's incredibly hard. 

it's also motivating.  it makes you read more.  learn more.  you want to make less mistakes.  anything to avoid that feeling of having to tell someone it was your fault.  i know it will never completely go away.  i'll never stop being human.  i will. make. mistakes.  but the fewer the better.  because even if the public forgives me, it's so incredibly hard to forgive myself.

so this is a bit of where i'm at these days.  i got a bit of good news yesterday, but i can't share it until after tomorrow.  cliffhanger, i know.  just be patient. (:


  1. big hugs, girl! my mom has dealt with SO MANY lawsuits over bullshit. and i feel so terribly- i mean, like you said, you are only human. you are not perfect. you cannot cure cancer just because you saw it. and it sucks, because the public DOESN'T think you should or CAN make mistakes... so they run off and sue. and then you have that headache to deal with.

    boy, im making you feel better, right?

    i guess just know, it's not the first time nor the last you'll feel this way? and all you can do is be the best dr emily freaking fleming on the planet.. and, guess what? you've already got that covered (;

    and if you want to change your middle name now to "freaking", you can. and should.. imagine greeting your patients, "hi, i'm dr emily freaking fleming, how can i perform a miracle on you today?"

    one more thing and i promise i'll stop: momma just had to give a deposition for a suit where she didn't catch the broken finger.. when the patient came in for back pain. and never complained or mentioned said finger. hashtag idiots

    1. No joke. I just wrapped up a review for a similar thing -- patient came in with one complaint and then came back about a year later wanting to file suit because here PCP is now recommending surgery over an entirely different complaint. Grr.

  2. I've thought about that for a looooong time- how doctors are humans, too, but their mistakes happen on a much grander scale than a plumber's or IT specialist. It's counterintuitive to put that kind of responsibility with a schedule that demands stress, exhaustion, on-your-feet all day (and night), a lack of "me time" or home life to recharge and maintain balance... thankfully, no one directly in my life has ever been affected by a doctor's mistake, but it does seem strange that the plumber has set hours and charges 3x as much to fix a leaky faucet at 6:30 PM or on a Saturday, but doctors not only have to work non-circadian hours but without any consistent schedule (like only nights or something).
    I'm really sorry you've gone through this, and had to re-establish your human fallibility. It's much easier to just get everything right and be the superhero you've got inside, right?!
    I can hope that your patients and their families are able to respect your honesty, your ability to say "hey, I screwed up, let's fix this/figure out what I can do to change this", and hope that your mistakes are always fixable and changeable- even though it's not likely. And I hope above all else that, should I someday be a patient or family member of a doctor on a 30 hour shift who's tired and stressed and left the house mid-fight with her/his spouse and dirty dishes in the sink and a kid who just puked everywhere for no clinical reason- I can remember that she/he is human, too- and deserves my compassion, even through any anger and frustration I might feel.

    Here's to your good news- what a way to have the social media world in suspense!!

  3. My hubby is a psych resident (intern year) and he just went through an experience that has changed his view on his career forever. Traumatizing, sad, scary and educational all at the same time. Those are some heavy emotions to try to swallow and digest at once! I cannot place myself in your shoes (or his) but I have the up-most respect for the work you and your and your colleagues around the world do. I can't imagine how difficult those bad days are, but just know that you have plenty of supporters around you - for if it weren't for people like you, we wouldn't have all those miracles and stories of survival, either.

  4. I don't even know you but I think you're one hell of a doctor, Em! I know I am harder on myself than anyone else - but I think you're right when you say that it motivates one to do better and make fewer mistakes. Keep your head up, girl! :)

  5. Total cliff hanger!!!! Being a Doctor is only for certain people...heck., being in the medicine field! But I am sure you have done for more good and great things, than the mistakes. We are all human <3 My sister is an RN and I've heard her talk of these things. Luckily they do training classes somewhat often in the hospital she works for. Excited to hear more!

  6. i absolutely can not imagine doing your job. thinking about the pressure send me into an anxiety panic. hearing all the stories my parents tell me about ER/hospital/clinic life is absolutely crazy.

  7. i know the result!!! perks of following the cutest doc in da world on instagram! you are an inspiration! seriously. XOXOXO !! congrats!

  8. Congrats :)

    One of my mentors always tells me that the day I am not having to look something up or go home and read about it is the day that I should be worried. If I thought I had all the answers already, there would be issues. I keep telling myself this because I hate feeling like a rookie.

  9. I just finished Delivering Dr. Amelia by Dan Shapiro. Strongly recommend. It's all about a doctor making a mistake. I think you would enjoy it.

  10. em, thanks for sharing this. you are a brave one and it's eye-opening listening to your struggles and triumphs. i'm a fresh med1 (i know, soooo green!) and it feels startling to think that sooner than we expect, playing doctor ends and the world is thrown on our shoulders to bear. from what i've experienced so far, em seems high energy and interesting.

    i'm interested in your life and adventures and happy to be your newest subscriber :)

    It would make me happy if you visited too!
    pandaphilia fashion

  11. It sounds great! I heard that she's one of the best doctor and one of my friend is one her patient and she really gives good services.

    eye doctor irmo sc

  12. Hi! I'm new to your blog. I just wanted to say thanks for sharing this and being so real! Such a hard task doctors have and I applaud you for being willing to take that burden on to help people. Also, a few weeks ago I heard a lecture on NPR about forgiveness in medicine. I found it really interesting and maybe you will too. I found the link here: http://tpr.org/post/role-forgiveness-medicine Thanks again for sharing! :)


your words are like music to my soul...and if you leave a comment, check back here for a response.

Related Posts Plugin for WordPress, Blogger...

the doctors fleming All rights reserved © Blog Milk Powered by Blogger