Wayfaring MD

I am a family medicine resident who likes to highlight the hilarious in medicine as I write about patients, medical school, residency, medical missions, and whatever else strikes my fancy.



Disclaimer:
HIPAA is for reals, folks. All of my "patient stories" have been changed to protect patient privacy. I will change any or all identifiers, including age, location, race/ethnicity, sex, medical history, and quotes.
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The only thing keeps me from wanting to pursue medicine is the drive to help others. I also always wanted to travel and be a humanitarian aide worker. I hope to help create social reforms that can relieve poverty and promote social mobility. I also want to help those who have less access to healthcare and education. I can’t communicate well, I am not an effective leader, I panic easily in unfamiliar situations. I don’t know if I’m being realistic enough to pursue medicine, what are ur thoughts? - vivavivalavidala

I’m sorry, but I’m not seeing your point. Why would a drive to help others keep you away from medicine? Helping others is the generic reason most med students give for why they want to pursue medicine. I mean, you pretty much just named half of the reasons why I did go into medicine. Seriously. And I had pretty much all of those doubts when I started.

Lemme remind you about Moses, whose life story, regardless of your religious beliefs, is a pretty amazing study of how a wimp becomes a great leader. Back in Exodus 4, God tells him to go talk to Pharaoh and lead the Hebrews out of Egypt. Did you get that? God literally talks to him and tells him what He is going to help him accomplish. And what does Moses say in reply? “Pardon your servant…I am slow of speech and tongue.” He’s all “yo God, that’s nice that you have put this calling on my life to do huge big things for these people, but I don’t think I’m cut out for it because I got a D in my college public speaking class”. (That’s the Wayfaring International Paraphrase for ya.). But God comes right back at him and says, “Who gave human beings their mouths?…Is it not I, the Lord?… Now go; I will help you speak and will teach you what to say.” How clear is that? God calls him to do something and He equips him to do it.

Life callings don’t come around just for funzies. Your interests and talents are there for a reason, even if you don’t think you’re up to the challenge of pursuing them. If there is a calling on your life to do something, God will provide the equipment you need to accomplish it. He may even make use of your shortcomings.

As for your doubts, I don’t think any of them are good reasons to NOT pursue medicine. I know plenty of introverted, shy doctors who avoid the spotlight and are still great doctors. But just because you don’t feel comfortable in certain situations now doesn’t mean you can’t develop some confidence over time. Come on girl, fake it til you make it.

Communication and leadership skills can be built and acquired over time. I mean geez, the first time I had contact with a patient I ran out of things to say after like 2 questions. That stuff comes with practice.

If you want to be a better leader, observe leaders that you admire and think about what qualities they have that make you want to follow them. You don’t have to be in an official leadership position to practice being a leader. Practice leadership skills in your daily life and people will begin to see you as a leader that needs an official position. Also, you don’t have to be in a leadership position of any kind to be an effective doctor, humanitarian worker, or community activist. Every cause needs good workhorses to carry out the leaders’ visions.

Also, who doesn’t freak out a little in unfamiliar situations? If you had told me as a first year medical student that I would be able to confidently run a code blue, I’d laugh in your face. Back then I couldn’t take a patient’s blood pressure confidently. But I learned and moved on. You know what helps? Pursue scary new experiences. Face your fears. Each small new experience builds on the one before it, and after a while you’ll be doing things you never dreamed you could handle 10 years ago. 10 years ago I got on a plane to go to Central America to “rough it” in a nice hotel and work in mobile medical clinics for a week. It was literally hundreds of miles from my comfort zone. But now I regularly travel overseas and get in crazier and crazier situations every year.

Lastly, you don’t have to be a doctor to do the things you want to do. You could be a social worker, public health worker, humanitarian aid worker, or even a no-title Joe Schmo who chooses to give money, time, and effort to worthy causes. Pursue your calling, not a title.

Asker Anonymous Asks:
1st year DO student, I think I may have failed anatomy. Is it all over or is it still possible to become a doctor? Is the probability of matching anywhere great enough to justify not dropping out and avoiding the 300k?
wayfaringmd wayfaringmd Said:

Ok, are you chilled yet? Calming thoughts…calming thoughts…calming thoughts…

Now. Do not freak out and let your medical career be over before it ever starts. You’re not even sure you’ve failed yet! Check with your school and find out what their policy is on failed classes. Most med schools have some sort of remediation program in place for when you fail a subject. Mine had a limit of how much you could fail before you were asked to repeat a year or leave the program, but one class is usually below that limit ;). Definitely DON’T drop out. 

Think about it this way: med schools weed people out pretty heavily during the admissions process, and when they accept you, they’re basically saying, “we’ll do what it takes to turn you into a doctor.” So more than likely they have a system in place to get you up to speed.

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Hi there WayfaringMD, I am currently in graduate school and anticipating to apply to medical school soon. I know I want to be a doctor and have some experience that further pushes my desire to become so. However, one of the factors that hold me back is my fear of “screwing up” that may lead to patient detrimental effects or even death ( ie: medications, etc.). I have heard of some residents messing up procedures and I am so scared of things like this. Is this normal and how do you cope? Thanks! -moveoverstyles

The fear of screwing up is totally normal, and I suspect it’s a fear that never really goes away, no matter how long you are in practice. We are not just afraid of making mistakes, but of the consequences of those mistakes. We worry about hurting patients who we intended to help, losing our jobs, being sued, and ultimately, losing the respect of others and our own confidence in our abilities

We all screw up at some point. That’s why we call it practice. Every patient encounter prepares you for a future one in some way, and today’s screw ups prevent tomorrow’s. 

How you respond to this fear is what really has the potential to make or break you.

  • You can let it motivate you to be a continual learner.
  • You can deny the fear and become arrogant, which is much more likely to lead you to a screw up situation.
  • You can let the fear overwhelm you to the point that you can’t be an effective doctor, or let it completely prevent you from trying to become a doctor.
  • You can turn the fear of screwing up into a healthy respect for the complexity of the human body, which will lead you to be a more thorough thinker and examiner.
  • You can let the fear be constantly on your mind and practice “cover your @$$ medicine,” which is hurtful to the system and your patient. 
  • You can accept the fact that you will at some point screw up, and try your best to learn from those mistakes. 

Also, remember that the whole point of residency is to give you a few years of experience with a safety net of attendings available to you to keep you from killing patients. We’re all a bit arrogant and we all wish that we could know everything, but the fact that we can’t know everything is what scares us. When you first start residency, you’ll be scared of every single order you sign. But as you progress in your education, the things that once were scary become familiar.  

So how do you cope, moveoverstyles? You make sure you’re always learning and you try your hardest to say humble. 

Asker Anonymous Asks:
Hi Wayfaring! I love your blog- I happened to stumble upon it while I was in college and a lot of stuff resonated with me as a Christian and a premed! I am finally an MS1, and it's only been 3 weeks, but I'm already feeling quite discouraged. The amount of information just seems so daunting (our first test is coming up in a week!) and it's hard for me not to compare myself to others/to not worry/panic etc. Do you have any tips for dealing with the stress that comes with being an MS1?
wayfaringmd wayfaringmd Said:

Here are two good posts I wrote a while back about the stress of med school. 

But to add to the advice, here goes:

  • don’t dwell on the “I can’t”s and the “this is hard”s and the “I’m not smart enough”s. We all think we’re not good enough from time to time. But you wouldn’t have gotten in med school if a committee didn’t think you were capable of making it through. 
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  • form a solid network of support people. You need fellow med students in your class and above you (because they’ve just been through it), as well as non-medical people you trust from your family and friends to be your rocks. These are the people you vent and complain and cry to. It helps, I promise. 
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  • If your support network is weak, seek help from school counselors, trusted advisors or professors, or professional help with a counselor. Because hey, counseling is the jam.
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  • take breaks. Find things to look forward to outside of school like weekend football games, camping trips, exercise, visits to see friends and family, etc. These things will keep you going when you’re trudging along, and they’ll help you relax when the time comes.  
  • develop a study system that works for you and stick to it. The more you change things around, the more stressed out you’ll be.
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  • Stay organized. Take a day to get your life together and make calendars, lists, whatever you need to study and live life efficiently. It’ll be worth it. 
  • Take care of yourself as best you can. Don’t eat junk every day. Try to exercise. Keep up with your dentist appointments (geez, advice I could have used about 3 years ago). If you’re falling apart physically, it’s easy for your mind to follow.

Hope these things help friend!

 WMD

Lately I have been feeling like medicine isn’t worth all the sacrifices in life and I have also lost a lot of confidence since I failed an exam for the first time. Any advice to someone who feels like they’ve lost hope? -anon

I’ve had this question sitting in my inbox for several weeks now. Sorry anon! I had a hard time coming up with a new answer to this question, which I seem to get a lot. TNQD wrote a post on this subject recently with some good questions to ask yourself to find out if the sacrifice really is worth it to you .

In short, I think that if you feel like medicine isn’t worth all the sacrifices, then don’t plunge into it yet. At least take some time and figure out your life.

You will regret jumping in to a pursuit you hate much more than delaying it for a semester or a few years. Plus there’s that whole med-school-is-disgustingly-expensive thing to take into account. I’m not sure why all the pre-meds have got it in their minds that if they take time off to figure out their interests, or if they pursue different paths for a little while, then they never can go back towards medicine. It’s just not true. 

Also, there are SO many options besides being a doctor that allow you to have a career in medicine. All career pursuits will require some sacrifice, so you need to figure out what’s acceptable to you and find the path that fits you best. Cranquis just shared why he might have considered a career as a PA instead of an MD if he had known about these options. 

Now if one failed test is your reason for giving up, that’s LAME. If I had quit after my first failed test, I never would have made it past organic chemistry. Bad grades happen. Learn from them and move on. You gotta put the past behind you. 

And as for losing hope, I have written a lot on how to cultivate motivation and avoid depression and burnout. Take a vacation. If you still feel hopeless at the end, you’re probably depressed. If you feel refreshed and ready to start anew at the end, you were probably just a little burned out. But beyond all encouragement I could give you, I think my best advice would be to just go slow. Don’t rush into medicine. Be absolutely sure it’s where you’re supposed to be. 

I am a senior in high school and I want to become a doctor, but medical school seems… Tiresome and depressing. I feel like once I get there I’ll be so isolated and alone that I will give up. How does one handle that? It just seems so daunting to me. But medicine is my passion and I don’t want to give it up! -scienceofthes0ul

Well friend, you have judged medical school correctly…sort of. It absolutely can be tiresome and depressing, and it is at times (and residency moreso). But the cool thing is that when you’re tired and depressed, most of your friends are probably feeling the same thing. 

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That doesn’t sound very comforting, but it kind of is. You will be surrounded by people who are just as miserable as you are, and they can empathize with you and you can use each other to get through. It’s funny, I spent less time with my friends in med school than I did with friends in undergrad, but I was much closer to my med school friends, and I think it’s because of this miserable dynamic. 

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Take my best good friend, for example. We somehow managed to get every 3rd year rotation together, which was a godsend. She kept me sane, for real. And during our 4th year when we parted ways for much of the year, we still called each other almost daily to share crazy patient stories, catch up, and commiserate. 

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But just in case you’re not lucky enough to find a best good friend in med school, here are some tips to avoid isolation, depression, and burnout. 

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Hey fourth years, how great has fourth year been for you? Amazing right? I told you it would be. Like all good things, fourth year must come to an end, and the beginning of that end is, of course, RANK LISTS. Rank lists are due February 20 (and if you didn’t already know this, you need to step up your game yo), and I’m sure you guys are all freaking out about them a little bit. 

A close friend of mine e-mailed me recently about her rank list decision making, and she said, 

I have been expecting to have a “big moment” of sorts where the lights come down from heaven and God says “this is where you are supposed to go.”

We all hope for that feeling. That moment when it’s all clear.

So far, that hasn’t happened for her, and I imagine it hasn’t happened for many of you. I had my own little rank list crisis last year (btw, I matched my first ranked program, but I won’t tell which of those two it was), so I totally understand the frustration and the worries and fears associated with making this list that will determine the course of your next 3-7 years. 

So here’s a little advice to consider in your decision making:

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Just remember, no matter how tough school and life get, it could always get worse. 

For example, you could have neurogenic bladder and have to catheterize yourself… and also have Parkinson’s.  

Hi, I’m a second year medical student, I finished an exam today and I did well, but I came back still feeling stressed, thinking how I’ve got a long way to go, it scares me, and I live with someone who is so competitive, it makes me so tensed:( help - victorianavina

Ok, repeat after me, victorianavina:

Hakuna. Matata. Hakuna. Matata. 

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In all seriousness though, the test is over.

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Hey Doc! So I just took my pharm final today and I know I failed it and failed the class as well because I haven’t been doing well. Have you ever failed a class in med school? How did you deal with it? I feel so incompetent. I just need someone to tell me HOW TO STUDY and LEARN/RETAIN the material. I’m not stupid right? It will get better right? Am I going to kill my patients or be jobless.. I also feel like I forgot my anatomy and biochem…what am I doing in med school!? –Anon

The short answer to “has WayfaringMD ever failed a class” is yes. My school was weird and our subjects were taught longitudinally throughout the year rather than in semester blocks, so you were required to pass each subject for the year overall. If you failed, you had to remediate the subject. I ended up failing 2 subjects by a narrow margin and had to remediate them before I could take Step 1. 

How to deal with failing? Hakuna matata. The fail is already done. You can’t change it, so don’t get down about it or stress over it. Just focus on doing better on your second time around. Change your study habits and techniques. Try something different, because clearly what you did before wasn’t working. However, don’t fall into the trap of spending ALL your time on your “bad” subjects and neglecting your “good” subjects, because you will find your overall grades dropping. Just because you didn’t fully grasp pharmacology on your first go-round doesn’t mean you won’t get it eventually. Remember, medicine is a lifelong learning process. Keep working at it, and one by one the concepts will come to you. 

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Asker cityhibiscus Asks:
Hi! I'm an undergrad student who is not premed, but I was just wondering: In your journey of becoming a doctor did you ever feel inadequate? Like you didn't possess the potential to ultimately become a doctor? Thanks in advance!
wayfaringmd wayfaringmd Said:

Absolutely. I still feel inadequate on an almost daily basis. I’m definitely not the most confident person on the planet. I firmly believe I am where I am today (and am surviving it) because it’s where Jesus wants me to be. Without his guidance, grace, and power, I would have broken down into a big puddle of jello by now. 

wayfaringmd:

Can you give me tips on dealing with depression? I’m a second year med student (on a international university, so is second year of six) who really loves medicine, especially surgery, but feels that does not have what it takes to be successful, to be a good doctor. I’m constantly thinking, “I’m not good enough, not that smart, I don’t have the abilities…” :S (can you please answer this on anon?)

I once told my mentor (and imo the best freaking doctor in the history of ever) that I didn’t feel like I was smart enough to be a doctor. This was like late in my fourth year of medical school, so I should have felt more confident, right?

Her (very wise) response? 

“I wake up every day and think I’m not smart enough for this job. That’s what keeps me reading and learning.”

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The point is, none of us feel good enough, smart enough, compassionate enough, competent enough, etc, at least at some point in time, if not all the time. The people who claim they do have everything under control are the ones most in danger of hurting someone because of their arrogance. Shoot, I have the “I’m not smart enough to be a doctor” thoughts at least weekly, and I’m already a doctor. 

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Hi! I know you’re super busy, but I have a question that I didn’t see answered in your FAQs. My friend recently started med school and he’s quite down. He says he’s behind in everything, unsure of himself and of his friends. What can I say to comfort him? What would you have wanted someone to say to you if/when you felt like that? Thanks! :) - mindsandbrains

I think the biggest thing to remember is that EVERY medical student, resident, or doctor feels this way at some point in their career (Even me, remember?). Many of them won’t admit it, so we end up with lonely, depressed, stressed out med students who don’t realize that there are literally dozens of people around them feeling the same way.

For me, knowing that even my mentors felt insecure some days made me feel loads better. 

But here are a few ways you can encourage your friend:

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wayfaringmd:

Can you give me tips on dealing with depression? I’m a second year med student (on a international university, so is second year of six) who really loves medicine, especially surgery, but feels that does not have what it takes to be successful, to be a good doctor. I’m constantly thinking, “I’m not good enough, not that smart, I don’t have the abilities…” :S (can you please answer this on anon?)

I once told my mentor (and imo the best freaking doctor in the history of ever) that I didn’t feel like I was smart enough to be a doctor. This was like late in my fourth year of medical school, so I should have felt more confident, right?

Her (very wise) response? 

“I wake up every day and think I’m not smart enough for this job. That’s what keeps me reading and learning.”

The point is, none of us feel good enough, smart enough, compassionate enough, competent enough, etc, at least at some point in time, if not all the time. The people who claim they do have everything under control are the ones most in danger of hurting someone because of their arrogance. Shoot, I have the “I’m not smart enough to be a doctor” thoughts at least weekly, and I’m already a doctor. 

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For those who missed it due to late night posting. 

Can you give me tips on dealing with depression? I’m a second year med student (on a international university, so is second year of six) who really loves medicine, especially surgery, but feels that does not have what it takes to be successful, to be a good doctor. I’m constantly thinking, “I’m not good enough, not that smart, I don’t have the abilities…” :S (can you please answer this on anon?)

I once told my mentor (and imo the best freaking doctor in the history of ever) that I didn’t feel like I was smart enough to be a doctor. This was like late in my fourth year of medical school, so I should have felt more confident, right?

Her (very wise) response? 

"I wake up every day and think I’m not smart enough for this job. That’s what keeps me reading and learning."

image

The point is, none of us feel good enough, smart enough, compassionate enough, competent enough, etc, at least at some point in time, if not all the time. The people who claim they do have everything under control are the ones most in danger of hurting someone because of their arrogance. Shoot, I have the “I’m not smart enough to be a doctor" thoughts at least weekly, and I’m already a doctor. 

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