If I were to use one word to describe my ED rotation, I would use the word “hell”. In saying this, I feel that I have learned an incredible amount of things from my ED rotation, but at the cost of my self esteem, and perhaps a little bit of my sanity.
It wasn’t the stress of seeing unfamiliar patient presentations that freaked me out the most, but rather in dealing with the senior doctors and the culture of degradation of junior doctors.
As junior doctors, we were thrown in the deep end. We were doing the same job that a registrar in ED would be doing, working up the patient, performing appropriate investigations, and making referrals. It was tough work.But this tough work I could cope with. It was even challenging, and something I learned a lot from. The thing I couldn’t cope with, were the staff. Not all were terrible, but I could say that a few were quite bad, with one particular man who seemed to be hated by everyone, including surgical registrars.This man yelled at me on the second day of work. I got yelled in front of almost all the other ED doctors for asking my senior doctor to describe an open fracture he had seen earlier that day, so that I could relay it back to the orthopaedic doctor. Words to the effect of “incompetent”, and “idiot” were used. That night, I couldn’t sleep, dreading the next day and fearing how it would turn out. It wasn’t until just a few days ago, that I found out other colleagues have cried at home from this very man yelling at them.
And so, for the next few weeks, I was mentally tortured by this very man who we had to run all our cases through. He would question my competence as a doctor, carefully pointing out my mistakes, and how I had forgotten to do things such as chart regular pain medications, hence why the patient is suffering excruciating pain.
On more days then not, I sat on the edge of my bed, thinking about the mistakes I made, and questioning myself whether I was competent or not. It was self abuse, and completely self defeating. I would dread the next day that I had to get up to go to work. Finishing work was the most relieving feeling ever, but on days that I was yelled at, or pointed out numerous mistakes, even that feeling of relief was taken away, to be replaced by frustration, anger and thoughts of worthlessness at the end of my shift.
To me, I felt worthless at my job. I wasn’t getting the support I needed, I never got the encouragement or acknowledgement that I was learning from my mistakes, or doing a better job than I was doing in the past. They didn’t take the time to explain my mistakes, and how I could avoid such mistakes next time, but they pointed out my mistakes, reinforcing the message that I was doing badly. In hindsight, I wasn’t doing badly, but I was doing something in which they held unrealistic expectations of me as a junior doctor.
What doesn’t kill you only makes you stronger right? In that sense, I feel stronger having put up with such degradation, and the subjected self torture. The biggest lesson I learnt was in dealing with ***holes in medicine. Learning to deal with other people – it’s an important life skill, and it will surely help you to survive in this big bad world.
The Placebo Effect (and Medicine) 