Doubt

It happens every 4 months, so by now I really shouldn’t get surprised by it – I am transferred on my conveyer belt of doctor training to a new specialty in medicine. The frustrating thing about this move is not that I am resistant to change or experiencing new and fascinating (ok, maybe not always) aspects of medicine but rather that 4 months is just the right about of time to be settled into a job. At 3 months, 3 weeks and 6 days I know the regular staff, the working day routine, what to do and what not to do (and the definitely what not to dos), and I am essentially settled. Life is good.

Then, all of suddent as that 3rd week of the 3rd month rounds itself off to the odd 7th day, suddenly the trap door opens below me and I am dropped into a whole world of doubt. 

You see what happens is, you finish one 4 month rotation on one day and the next (typically a Wednesday so that you can only do so much damage in the three days before the weekend) you start a brand new one. The treadmill on the new rotation doesn’t start on a slow speed with a gradual incline – it starts at 100% incline and break neck, eye-watering speed. Last Wednesday I was all of a sudden presented with thirty complex medical patients whom I knew nothing about, a ward that I had all the orientated ability of school kid on day 1 of their duke of Edinburgh scheme -and to cap things off I had my lucky pen had run out of ink. Never underestimate the importance of a good pen.

As first days go it was, well, awful. How do I measure it? Well, there are lots of parameters from the number of patient left alive at the end of a day, the number of relatives who have shouted at you, the number of toilet breaks (the number of toilet breaks inversely proportional to the busyness of the day), or the ability to consume food – more than the last Haribo sweet on the nurses station that has by that point been grazed by a two dozen partially washed hands and splashed with a hint of alcohol hang gel-MRSA fusion. That first day was however measured by the ultimate yardstick – the time you left work. In the case of day one of my new rotation this was a punchy 2 hours and 15 minutes after my shift formally finished. 

Joking aside, I am really not a fan of this swap period. It’s not because the new medical team are not nice or receptive – far from it – or that I have some longing to remain in my old rotation (as much as A&E was amazing, I’m glad to get my weekends back) since I am naturally hard wired to want to stretch myself – whether I enjoy it or not. The reason, rather ashamedly is that I always end up getting floods of doubt about my skill as a doctor.

The start of a rotation is always very exposing you see – it is raw, fast paced, unforgiving with time not waiting for you to catch up or get up to speed. With this fate I inevitably end up judging myself harshly, filling with doubt and worrying about my skill as a doctor. As such it was fair to say I hated my first day on the medical ward last week – an assault on self-perceived professional competence. Now as someone who sleeps like a log (and I mean really does not move until they awake with that tiny pillow-pool of dribble cradling the nights saliva) it rare for me to sleep badly. 

The first two nights after I started this rotation I slept awfully. Definitely no saliva pools but instead replaced with sore eyes that had stared at the ceiling of my childhood bedroom (home for Easter for the free chocolate obviously) from 3am until sunrise as I ruminate and dwell on the 4 months ahead. On the third night however when I awoke again at 3am I had a change of heart:

Sod this.

Having been enthralled with a bit of Bear Grylls Mission Survive on TVS the night before, I asked myself how can I survive better and change my mindset? This sounds ridiculous to many I’m sure but recognition of a problem, whatever it is, is the first step, however you find it. Plus, we all seek inspiration from different sources – and for me, not in an idylistic way, but more a respect of what he represents, find this in Bear Grylls. With that said, not to sound like narcissistic (something I’ve been accused of in the past) but I believe my parents have raised me and my brother incredibly well and given us all the tools we need to face challenges. So with this in mind at 4am I wrote a list. Now, I may regret this as I know some of my colleagues are aware of my blog now and may read this – but if I want to be truthful to the blog – I need not let that worry me. So here is the exact list I wrote:

  

We all encounter challenges in life; From the complex to the mudane. How we approach them is effected by an abundance of factors some of which are simply beyond our control. Someone once said, “if you can’t change something, then change the way you feel about it”. Composure, calm, positivity, tenacity, focus, good humour, all supplemented with support and teamwork, are all essential to win over any doubt that may creep into your mind. Looking after the body and mind with good hydration and nutrition is as critical too – unless of course you want to run your batteries dry.

I can succeed in this rotation just as you can succeed with whatever challenge you have this week. So with that, knock away the negativity and doubt, drive in the positivity and I’ll see you on the other side….

Nick

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