Reality check

Today was one of those up and down days, when you can’t quite figure out how to feel. I had a classmate compliment me on my clinical skills, which was totally unexpected and really nice to hear. Especially since she and some of my other classmates had been talking about how I always seem to know what I’m talking about. (In my head, I’m thinking “Me? they think I know what I’m talking about? HA!”) So that put me in a pretty good mood, gave me a little (much needed) boost of confidence as I went about my various tasks.

Then, one of the nurses taking care of one of my patients asked when my baby was due. Yes, it actually happened, I stood there for a minute just totally frozen, hoping I didn’t actually hear those words. I sucked in my gut and answered “I’m not pregnant. I just had a baby three months ago”. She didn’t even seem that embarassed, and launched into asking me questions about my son, wanting to see pictures, the whole nine. I suspect she was terribly embarassed (she should have been, anyways!) and was trying to cover it up. But inside I was just dying. I’m only 12 pounds over my pre-pregnancy weight, which doesn’t seem like that big a number. I think it’s the fact that these pounds seem to be mostly congregated in my belly, where I’ve never had a problem with extra weight before. I’m very sensitive about it, as you might imagine. I’d love to say I love my body because it bore a child, blah blah blah. And I’m proud of the things my body has accomplished in the last year. It doesn’t mean I’m going to walk around in a bathing suit anytime soon.

On top of that, I have a very unpleasant patient. Cocaine user admitted for chest pain and shortness of breath. (Hello, you weigh 350 pounds, smoke crack, and don’t show up for dialysis, of course you don’t feel good!) His chief complaint this morning was that he was starving. He refused to let us draw his blood because he was hungry. I’m not sure how being hungry and having blood drawn are related, but apparently there is some connection. He refused to go to dialysis unless he ate something. We tried to get him home with a follow-up stress test but he decided to stay in the hospital overnight to get the test. Even thought he tried to tell me the test was too dangerous for him. This was after he argued that keeping him without food was bad for his heart. (Um yeah, you are so thin and frail you’ll just die without a meal. Grr).

The day ended on a high note, when I found out my class rank for 3rd year was good enough to put me in the top quarter of my class. That was a nice feeling. A little bit of validation to cap off a somewhat trying day. I’m settling into my routing, but I still have no confidence in my ability to be an intern, I’m terrified (like full on panic mode) I’m going to harm a patient. I need to get over it, but I think the only way to do that is time. I’m going to ask my resident tomorrow what I’m doing right and wrong. That way I’ll have something concrete to work with instead of guessing. Sometimes having high standards for yourself is nothing but a pain.

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