Residency Diaries Series #9: I want to quit medicine (COVID Part III)
During the heaviest months of the pandemic, I fantasized about quitting residency and leaving medicine everyday. At the time it didn’t seem like my situation or the way I felt about my job would ever change. I didn’t think to blame it necessarily on the globally stressful event that was traumatizing all of us.
That’s the hardest thing about tragedies and traumas. I think we tend to lack a certain perspective when it comes to processing these big emotional events. We forget that life was once livable and even pleasant and rewarding. We find it hard to imagine that things will get better with time.
I didn’t have enough emotional stamina to process what was going on in the hospital in April, arguably when things were at its worst in New York. I didn’t even start writing about certain events or patients that left a big impression on me until June.
I cried almost every time as I was heading into work. I thought about the step-by-step logistics of telling my program that I was going to quit. Telling my parents. Figuring out how to live my life with the massive amount of medical school debt that I now have no clear way to paying back.
I’m sure daydreaming about what I can do with my life after medicine probably helped me escape my reality for few precious moments at a time. A bookstore. Maybe a cafe. Maybe an AirBnB.
Now I don’t feel like quitting everyday. I don’t cry every time I have to go to work. Things are, for the most part, better and manageable. As the COVID cases rise everyday across the country, I hope that I’m better prepared emotionally for this winter. I don’t know if it’s going to be as bad as it was before. But I hope I can keep holding onto my perspective. It’s not forever.
5/1/2020 Friday 4:33am
The way I’ve coped with this COVID-19 pandemic is by fantasizing about leaving medicine altogether. I am about 3 weeks into my NICU (neuro ICU) rotation with about 80-90% COVID patients in the unit, so it’s more like a MICU (medical ICU).
In my other life, I own a bookstore/cafe/event space. There’s always fresh coffee and baked goods. I organize and clean the shop. People come to my shop for comfort (not illness and death). I read in the shop during my free moments. It is a place of joy, rest, and imagination (not pain, suffering, and death).
I brought up this idea to my mom who with some hand-waving said this is all part of my training process. She said this was all expected-- and that my dad also felt the same way as a resident. My dad, who actually has been a resident in New York City (with his language barrier no less) said nothing.
Part of why I feel like I want to quit is because I feel like my reward system for being a doctor is all wrong. It’s all external-- grateful comments from patients and their family members, the supposed respect and prestige the title carries, even the 7pm applause during the time of COVID as I contemplate quitting and leaving all the patients behind. Did I go into this field with the wrong mindset?
I look at the rest of the NICU team and see that there’s something a little different about them than me. They really care about the things they’re learning about and practicing. They have research aspirations. They truly want to become experts in their field. I listened to a neurosurgical resident respond to a consult about a patient with intracranial hemorrhage. I listened to him give recommendations over the phone and thought about how satisfying and fulfilling that must be.
The thing about emergency medicine is that within the walls of the hospital, there’s always another doctor who knows more than you about a topic (about asthma, cardiac arrest, trauma, intracranial hemorrhages, etc). You’re always the one who knows the least compared to our nephrologist, neurologist, neurosurgeon, cardiologist colleagues. I think some part of that plays a role in how motivated I feel to learn. I often feel like I just stabilize the patient and pass them on to someone who will take over the care.
Of course the counterargument is that we as EM doctors are supposed to be experts in resuscitations and initial stabilization of unstable patients. In general codes in ED seems to be a lot calmer compared to ones on the floor (unless it’s an ICU patient who was going to die either way and everyone in the room knew it). We know a little about almost everything (or at least we’re supposed to). And I suppose that in itself is a skill-- it’s one of the reasons why I wanted to go into EM-- to know a little about everything, to be the most useful person in any situation outside of the hospital.
Anyway- I know this is more of a me-problem. There are plenty of EM residents and attendings who are motivated to learn/research/teach and excited to become leaders in their field. I’m just not there right now.