The AAS Ethics Committee continues our 2023 blog series, presenting member’s submissions from this year’s essay contest. We are also delighted to promote the 2024 Art and Essay Festival. Click HERE to learn more about this year’s event and submit your work.
I was tired. Not simply sleepy, but bone-tired. My body hurt and ached as I dragged myself for the perfunctory ritual of getting ready for the day. Although I had not been on call, I couldn’t sleep last night. I dreaded going to work the next morning. The mere thought of even returning to the hospital caused my chest to clench, and I stayed awake at night, staring at the ceiling, anxious about every interaction I would have to face the next day. I went to bed tired, but I woke up exhausted.
Despite this, I dragged my body out of bed and into my car. I put my keys in the ignition, and after a pause, started the car and began driving. With every action that put me closer to the hospital, I felt like my mind and body were just screaming. I just couldn’t bear the thought of having to put myself out there just to work with ungrateful faculty, demanding families, and nurses who would challenge my every order.
I had given everything to be at this training program. I had sacrificed my personal time, my health, my hobbies, and my family life. The operative experience was high quality, and the fellowship position I was in had been highly coveted. But since I arrived, I felt like my enthusiasm and spirit had been whittled away.
Now, even after the most intricate surgery, I could not find any satisfaction in my work. I couldn’t even enjoy my personal time. I had recently gone on vacation with my family- the entire time, and I spent most of the time fuming over all the negative interactions I had had over the last 24 hours of call.
As fellows, we took in-house call. It was a brutal call, mentally and physically demanding as we dealt with patient calls, transfer center calls, ED, ICU. Our call room had been degraded to another smaller, less convenient room deeper in the bowels of the hospital so that the faculty, who were not in-house call, could have a space in case they were called into the hospital to operate and wanted to sleep. I protested this move and was told, “If you don’t like it, you don’t have to be here.”
It was a slap to the face. It was insulting, given what I had sacrificed to be where I am now. At that moment, it became clear what I was to this program. I was just a body- expected to shut up and take call, to take care of patients and families, to just take care of it all, and do it perfectly, without complaining, and be grateful to be there.
The drive to the hospital was only a mile and half. I had wished it were longer. The light was red at the stoplight- it was early, the streets were empty, and it was dark.
I had an intrusive thought: If I just drive my car into that brick building hard enough, maybe I don’t have to go to work… It was an appealing thought, but I quickly rationalized it away. Because I knew that if I could not work, then the faculty would not care, and my co-fellows would just be burdened with more in-house call, until they found someone who could take my place.
It’s incredible that my “rational” reasoning to not ram my car into a building was because it would be a burden to my co-fellows. I didn’t even consider my husband and child.
I have obviously long moved past this time, but I reflect upon it often. This was not just a stressful time in my life- it was miserable. However dark my thoughts were, I never felt that I could take any care for myself- my health, especially not my mental health, my anguish, my rage, were not a priority. It felt burdensome, not just to myself, but to my other poor colleagues who would have to pick up my slack. Certainly, my faculty at the time did not care. It felt like a betrayal when I realized this- they were supposed to be my mentors, but instead I never felt like I was more than someone who was supposed to answer the pages and take in-house call.
The pervasive ethos is that “this is the way we’ve always done it, this is the way we are trained.” But does it have to be this way?
As someone who is now responsible for trainees, I now try to be cognizant of their needs beyond just providing surgical education. Providing a culture of caring is the least that we can provide for each other.
As much as I received the necessary training, it also feels like a part of my life was wasted. And that will be time I will never be able to get back.
Submitted Anonymously
Transitioning the Surgery Clerkship from Third-Year to Second-Year Medical Students: Lessons Learned