it gets better

The lowest point in my residency was in January of my intern year.  I was a Pediatrics resident back then, doing a month-long rotation on "Team 2," which is what we called the general inpatient pediatric team, with a focus on the patients on our liver transplant service.

It was a very long month.

I'd get to work at around 5:45 every morning to pre-round, and invariably leave after dark every night--not difficult, considering that, in January, it seemed like it started to get dark around 3:30pm every day.  I was there much later than that, of course--most nights I'd leave around 7:00pm, unless I was on call, in which case I'd leave at around 10:00am the following morning.  We'd have pre-rounds and then rounds, then attending rounds and work rounds, followed by teaching rounds and radiology rounds, with time at the end of the day for sign-out rounds.  Twice a week we'd have Grand Rounds and Chief of Service Rounds.  How we ever got anything done with all this rounding, I'll never know.  How I ever got to spend time with any patients in between all these rounds is even more of a mystery.  It just felt like a day of endless, endless scut.  Losing the forest for the trees.  It would be a day full of writing down numbers and pagers beeping and phone calls and faxes and entering computer orders, and not nearly enough time practicing medicine or spending time with patients.  And then I'd go home and collapse and wake up at 4:15 the next morning to go in and do it all again.

It was shortly after this that I decided to switch fields, to Anesthesia.

But this entry is not about me and my switching residencies (though this is easily the topic that I get the most e-mails about--I think I've addressed it a couple of times on this blog, but for the most fully fleshed out explanation of when and how and why I switched residencies, I'd recommend you check out the book, it's probably one of the sections I spent the most time editing in order to get the details right), it's about something else that I want to talk about, which is this: residency can be deeply depressing.

And let's get this straight.  I liked residency.  Really, I did.  Yes, it was hard, and yes, I was tired basically all the time, but I expected that, and now that it's over, most of my memories are affectionate.  Residency, like medical school, was full of stories, and many of them, in retrospect, are funny--not at the expense of patients, but at my own expense, because lord, how serious and inexperienced and bumblingly well-intentioned I was!  But that first January of my intern year, I was very close to being clinically depressed.  It just all felt so grim and featureless and endless, and I felt more and more like I was just some kind of task-programmed automaton, not like the doctor that I thought I was supposed to be at this point.

 I wanted to quit.  Not just quit being a Pediatrics resident, but quit medicine altogether.  I was unhappy.  I didn't like my life.  I wanted to be done.  I know that this comic was intended to be a joke, but there were time, real times, when I passed by a Gap or a Starbucks or whatever, saw that they were hiring, and seriously considered stopping by to fill out an application.  At least they don't make you take call at The Gap, folding chambray button-down shirts at 2:00am.

Now I'm going to tell you a secret.  Everyone who has been through a residency has felt this way at some point.  Everyone.

Maybe you're feeling this way right now.  So here's another secret.  There's more to life than this.  Even though it feels like residency is your life, it's not.  There's more to life.  There's more to you.  And it gets better.

It gets better.

There's this great line from "A League of Their Own," which I adapt and quote often. "[Medicine] is supposed to be hard. If it wasn't hard, everyone would do it. The hard...is what makes it great."  However, don't get me wrong, I don't equate suffering with nobility.  Suffering is just suffering.  All I'm saying is that it's hard, but there's more, and you deserve to experience all of it.

Don't let your residency consume you, and don't let it make you believe that there's nothing else, or that there are no other options.  There's always more.  There's always what's next.

And you know what?  If you're really unhappy, and you want to leave medicine, there's always that too.  It's OK.  There's no shame in changing your mind.  The shame is hating your life, really hating your life, and doing nothing about it.  Who wins in that situation?  Not you, not your patients.

It gets better.  I know it's winter, and winter for a resident is long (oh lord, it's so long, it feels like you'll never see the sun again) but it gets better.  Just remember that.  Remember that you're a person--an intelligent, good person with free will, not just a cog in a machine--and I swear to you, the rest will follow.