Wednesday, May 25, 2011

on dreams

The night before I return to work after having been on vacation, I always have an anxiety dream about anesthesia.  It's something that I hoped I would outgrow, and I guess I have to some degree, since for the entire first six months of my anesthesia residency, I had anxiety dreams about anesthesia every single night.  Most of these dreams had to do with the standard things that residents are anxious about--I had dreams about machine malfunctions, patients sitting up on the table in the middle of surgery, leaking canisters of volatile anesthetics that rendered me unconscious before I could reach the machine to turn it off.  But some of the dreams I had early on were completely nonsensical, like the one where I was at an airport and I was called upon emergently to resuscitate a sea lion.  Why was I in an airport?  Why a sea lion?  If this implies anything unsound about my state of mind, please also remember that I also had a young infant at the time, and the very fact that I was even able to sleep deeply enough to dream was a triumph in and of itself.

So anyway, the dream I had Sunday night was that I had to put a thoracic epidural in my own grandmother.  To what purpose it was unclear, but I do remember having to sit her up on the OR table and prep her back with Betadine while explaining to her in Cantonese what I was doing.  Aside from the construct, it was actually a very realistic dream, and when I woke up, I had to orient myself for a few minutes to decide whether or not my work day had ended or whether it was just beginning.

What anxiety dreams do you have about medicine?  Have they changed over time?  I would like to think that they will, or that I might at least at some point in my life be able to go on vacation without having to count on one full night of tossing and turning and dreaming with a pulse-ox tone backbeat.  But it's been more than 15 years since I last took a math class, and I still regularly have dreams about showing up for the big calculus final having not attended a single lecture (it's always something where I forgot that I registered for the class, and didn't realize it until the Add/Drop period had ended), so I don't have real high hopes that my medicine anxiety dreams will ever fully go away.


  1. I'm a lawyer and my recurring dream is that I didn't take a required class in high school, which means I didn't graduate high school and, as a result, I can't be a lawyer. The type of class and the point at which I start showing up to classes varies. Usually the class is history or calculus and it's the day before the final. My brain picks calculus and history because those are the only classes I couldn't fake knowledge of for a final.

  2. Anonymous10:13 AM

    I'm a nurse, and I frequently dream that I can't find my patients, or that I float around in a haze for my whole shift and never actually do any work.

  3. Lateness!
    In OB, getting to the board on time is mandatory - you get evil glares if you are three seconds late. And I am always 15 minutes late to everything. So I have nightmares about not being able to leave the house because things keep coming up. Eventually the whole day passes and I haven't left the house.
    (Which is a variation of the same dream I had in school, only I was late for an exam, not work.)

  4. Anonymous10:26 AM

    The night before I had to submit my match list, I had a dream that I had to rescue a baby from a flooding apartment. I'm in pediatrics.

  5. Anonymous11:01 AM

    I'm an MS3 aiming for a career in ortho. My ortho mentor is an amazing role model, sets high standard while also being incredibly supportive and approachable. I have had the opportunity to assist her quite a bit in the OR and after proving myself, she's let me do more with ortho tools (such a blast!), naturally under close supervision and step-by-step guidance. I have had dreams about messing up in the OR so badly that my attending completely loses her faith in me and my chances of ever entering the field are over. In real life, my attending would never let me do anything I wasn't capable of doing and if something was going wrong, she'd intervene in the blink of an eye. Or more likely, would prevent it from happening in the first place. Still, I would hate to disappoint her and keep doing my best to earn her trust and prove myself.

  6. I'm a nurse, and one recurring dream I have is that at the end of a 12 hour shift, I've just discovered a patient I didn't know I had, and so haven't done a thing for them all day .. no assessment, no meds, nothing. For whatever it means in dream language, the patient is always fine, and has no idea s/he was not cared for through the day.

    And my version of the dream that seems ubiquitous to every dreamer: the class you've never attended till the final exam: for me it is ALWAYS a history class. In real (awake) life, I hated every history course I've ever had to take, and am still sadly deficient in historical knowledge.

  7. I dreamed that I was an intern, and my resident told me I had to pre-round on my patients naked. So I did. But when rounds came, everyone else was wearing clothes and I realized that the resident was just playing a joke on me. I've had this one, and variations on the naked theme, a bunch of times these past few months.

  8. Anonymous4:58 PM

    I often dream that I am performing procedures on my late mother. As her cancer progressed to her lungs I watched her undergo many thoracenteses and usually that it is what I have to do. Sometimes it's more routine stuff like placing an IV or starting chemo. Many things that I watched healthcare professionals do to her when she was sick, but things that I never personally did.

  9. PedNP5:11 PM

    I have a recurring work dream where I am walking down the hall to see a patient and I keep getting stopped and called into other rooms or asked questions. No matter what I do I can't get to the room. Some days at work aren't too far off this.

    Another dream is that I will be at work/school and I suddenly realize I'm not wearing anything from the waist down (always fully clothed above the waist--I have no explanation for this). The rest of the dream involves me trying to avoid people while looking for pants but never actually finding a pair.

  10. I have my fair share of bad dreams, but my dear husband has the medical sort.
    He graduated from med school in 1992, but to this day dreams he has to repeat one class or another, or retake his boards, at least once a month.
    I'm sure this speaks to his general, er, humility in life more than anything...but there it is.
    I do believe the older you get, the more your subconscious likes to fuck with you.

  11. I'm not quite an M3 yet, so no hospital/patient/etc. dreams yet, but I have certainly had several dreams where it's like I never stopped studying when I went to bed. The most awful one was the night before a quiz on the GI bugs. I had been memorizing this gigantic chart before bed, and, of course, I dreamed of the chart. The only way I knew it was a dream, though, was that I noticed that the chart was all mixed up! (Thank goodness I noticed!) I definitely woke up more confused than I had been before bed, though! (And freaking EXHAUSTED!)

    I'm currently studying for Step I, and last night's dream featured a classmate. I don't remember the dream at all, but I woke up REALLY wondering whether I should alert her to get screened for Marfan's because she is (a) tall and (b) has pectus excavatum (thanks gross anatomy locker room days for that info!) It was a bizarre intersection of random studying facts and a curiosity I hadn't thought about in over a year. WILD the things our brains dredge up!

    Can't wait to find out what happens to my dreams when I'm actually seeing patients on a daily basis! I've never had a recurring dream, but maybe I'll finally achieve that level of terror!

  12. Anonymous10:04 PM

    I had a dream that I 'failed' the MCAT. :( It was scary.

  13. I have a friend who is also a nurse who repeatedly dreams of a hospital scenario, eh. I guess, yours is not an isolated case, for there are many who happens to experience dreaming about their jobs, repeatedly. Anyway, they say that our dreams is the extension of our waking life, so maybe your dreams are just a representation of your unconscious and telling you that you are really working hard on your chosen career, For even in your sleep, your mind is still working, eh.

  14. I'm a veterinarian, and my recurring dream is that I've taken in a patient to be hospitalized, put it in a kennel in the wards, and completely forgot to tell anyone anything about it, start its treatments, make a treatment sheet, run any diagnostics, etc. I usually wake up on the verge of picking up the phone to call the clinic, but then I realize I don't remember the patient's name, or why they were being hospitalized, or even whether it was a cat, dog, rabbit, tortoise, etc. I had this dream almost every night for the first 4 or 5 months of my internship, and still have it about once every 2 weeks.

  15. Also a nurse, and also consistently have the dream that I've forgotten about a patient for my entire shift (or that I've just faffed about and not done any work at all). The dream worries me so much that even when I'm awake and at work I will count my rooms several times to make sure I'm getting to everybody. (I'm not as crazy as that makes me sound though, I swear.)

    And I also have the ol' show-up-for-the-final-without-ever-having-attended-the-class dream. Or sometimes it's mid-semester and I know there's a class I'm skipping, but I don't really want to go and tell myself that it's only been 2 weeks, 3 weeks, etc... Lately it's been Spanish class, but other times it's Calc. Always something that I can't fake my way through, of course.

  16. Anonymous12:22 PM

    When I was in med school taking anatomy I dreamed I was dissecting my grandfathers corpse. Suddenly his corpse animates and begins chasing me around the room. I woke up sweating from that dream.

    Yesterday I dreamed I was attending high school and could not find my classes. Half way through I realized I have my high school degree, a bachelors and my MD. Why in the hell am I searching for my class?? I have some form of this dream about once a month.

  17. Anonymous4:50 PM

    My long-term recurrent dream is band - one night I dreamt our instructor put me in the trombone section as 1st trombone except, of course, I have never played the trombone.

    If I don't read something fluffy before bed I will definitely dream about patient care all night long. 2 nights ago my car was stuck in the snow but I never made it to the hospital as my ER shift tick, tick, ticked away...

  18. I tend to sit up in bed & talk in my sleep, especially if work has been particularly stressful. More often than I like to admit, while sleeping, I've sat up in the middle of the night, gotten up out of bed, all while thinking that I fell asleep on the job and need to check on a patient. I am usually walking out of my own bedroom before I truly wake up and tell myself, "I am NOT at the hospital" and "No patients are here!"

  19. I am a senior Emergency Medicine resident, and wake up in a full sweat, certain that I have left a shift and totally FORGOTTEN a patient, and not discharged/admitted/signed them out to anyone, and that they are still languishing in the ER. I admit.....I either call the hospital or log in electronically to our tracking board, just to make sure : )

  20. I'm an equine veterinarian, and I have dreams about a bad accident and injury I witnessed a number of years ago. None of the golf carts work, so I run towards the horse but can't get closer.

  21. I'm a bit late to the party, but ever since I matched and then found out where I'm starting (peds sick clinic) I've had this dream where a kid comes in with some vague respiratory complaint that looks/sounds like a URI and I turn around to get something or log onto the EMR and by the time I turn around to ask the mom something, the kid is in in full-blown distress flaring, retracting, tachypneic and he basically falls of the cliff in front of me. The actual underlying etiology varies, usually unknown.

    For some reason there's nothing around (no bag mask, nothing for intubation, no crash cart) and no one comes to help.

    I keep waking up looking for the bag/mask/ETT and calling for an attending.

  22. Anonymous11:22 AM

    This isn't a medical profession dream. This is more of a lowly pre-med dream. When I was studying for the MCAT, I would keep having this dream that I am in danger, and every time I attempt to dial 911, 411 or 191 or some wrong combination of numbers shows up on the cell panel. I would keep re-dialing but to no avail. I have not this dream since I got my scores back and am done with MCAT horror. But I am almost certain I will have similar dreams during USMLE and residency. Grrr....

  23. I once had a dream that I had to find out whether an elderly patient had a high-set deck (verandah/porch) or not, and if it WAS high-set then I had to organise to have it deconstructed and removed from her house before she came home from shoulder surgery.

    Clearly I felt a bit stretched by work at the time.

    The old stand-by nightmare (as repeated many times already) is the one where you either forget the patient or never manage to get to them, no matter how hard you try. I also love (not) the vivid dreams about patients who are currently under your care, and the dream is so real that you have to remind yourself on waking that you don't need to make sure to feed the donkey in their room on rounds the next day.

  24. Kandi6:41 AM

    I keep having dreams about shoulder dystocia failing all maneuvers, PPH and going into DIC, fetal distress with terminal bradycardia, ruptured ectopics with hands and feet flailing before taking them out, me delivering my own baby etcetc... you know, things that happen in real life for an ObGyn. Recently having a LOT of exam related dreams as I'll be taking my Part 2's soon.... and I literally wake up crying. This is pathetic! :p