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. Also, I am an anonymous internet person. Why should you trust an anonymous internet person to give you medical advice? Don't ask me, ask your doctor!
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Posts tagged "encouragement"
Asker Anonymous Asks:
I'm an incoming ms2 and I was wondering how you learned to accept things as they come and not fret about it. There's not a day/moment that passes by over the past year that I haven't incessantly thought about my residency prospects, and the thing is, I'm doing pretty well in school---I just feel burdened by this pressure that I feel my peers don't have as bad. I think the prospect of not meeting my expectations/becoming the doctor I envisioned myself as worries me most. Does it ever get better?
wayfaringmd wayfaringmd Said:

Hmm, that’s tough. 

I’m generally a very laid back, go with the flow kinda gal. I never had much confidence in myself, but I always believed that if God got me in medical school / residency, He would also get me through. It’s a lot easier to not stress when you’re trusting in someone else’s capabilities and not your own. My abilities are pretty mediocre, but I believe that if I’m doing what God wants for my life, He’s going to provide what I need to get through (here I am preaching this to myself on a daily basis as I start to look for post-residency jobs now). 

Sure, I still worry. Ask cranquis. He has had to talk me down quite a few times as I was blubbering on about trying to figure out what my next step after residency is. I still stress over these things occasionally. We all have days when we think we’re not smart enough or confident enough or compassionate enough or whatever, but you’ll have good days too. Your peers probably feel the pressure just as heavily as you do, and they’re bottling it up just like you are. 

My mantra has always been “do my best, do what God wants, and what happens happens.” If I truly do the best I’m capable of and am in God’s will for me, then I can’t really worry about the outcome. If the outcome sucks, it’s out of my hands. There must have been a plan besides mine in the works. If the outcome is awesome, well hey, yay me. 

It is completely okay to have these worries. Use them to motivate you to learn more and be the best student or doctor you can possibly be. You should always be striving to be better at what you do. But if your worries are consuming you or interfering with your work or are your main focus, you gotta do something to release them. You need an outlet. Blogging is great. Quiet nights in with a friend are great. I’m a big fan of coloring books and tea myself. Heeding the counsel of someone who has been through it or is wiser than you is always a good plan too. 

I can't really say everything I want to w/out going over the limit, so bottom line, I'll be a senior in high school and being premed scares me. It'd mean a lot to me if u could say something that wouldn't make premed sound scary. Thank u for ur time
wayfaringmd wayfaringmd Said:

Being pre-med wasn’t scary for me, but I’m naturally not a freak-out-er.  It requires a lot of hard work and dedication, but people do it every day! It’s certainly not impossible, and it shouldn’t be scary to the point that you can’t focus. 

When I was a pre-med, I had these awesome two competing delusions in my brain. One told me that I was definitely the stupidest kid in my class, and therefore I needed to work harder. The other told me that there was NO WAY that I wasn’t getting into med school, so I could relax about all my worries. Both thoughts, of course, were ridiculous, but they produced in me a balance of hard work and chilled-out-edness (oh yeah, I’m making up words left and right here) that turned out to work in my favor.

Even when I made C’s (gasp, C’s?!) in a few classes, I was chill enough to just work harder and not freak out about my prospects of getting into med school.

Being premed IS scary for a lot of people though, and med school is worse. I think it’s the unknown that makes it scary —will I pass this class? Will the next class be impossible? Will I get into medical school? Will I bomb the MCAT?

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Some people worry incessantly about their grades, other people’s grades, their volunteering, their application stats, whatever. But you gotta take things day by day. Don’t give any thought about the MCAT for your first 2 years of college. Don’t worry about your GPA or anyone else’s. Do extracurriculars that you enjoy, and not those that you think would look good on an application.

For this year, focus on being a senior. Take it day by day. Find a college friend who is premed who can mentor you and take some of the unknown and the scariness away for you. 

Asker Anonymous Asks:
Hey there. I've always wanted to become a doctor but recently I've been so depressed. I've been volunteering trying to remind myself why I wanted to be a doc in the first place but I'm not inspired. I wanna take time off but I need to tKe my MCAT before they change it. I need to mature like you said but I'm pressured bc of the test. I'm a senior in college and I can't believe I feel this way.
wayfaringmd wayfaringmd Said:

Why not take the MCAT now and then take some time off? You could go ahead and get it out of the way. But honestly, postponing it is not the end of the world either, even though it would mean having to take the new MCAT format. If you take time off and take the test in a more refreshed state, you will probably do better than taking it all “pressured”.  Either way, believe me, you do NOT want to start medical school in your current state. That’s a recipe for disaster. 

Also, this is important: if you continue in a medical career through medical school and beyond, you will experience TONS of times when you hate the work and don’t feel “inspired.” No job, no matter how cool, is going to provide you with a thrill or warm fuzzies on a daily basis. There will always be paperwork and long hours and difficult personalities you will have to deal with. 

Seriously though, take that break. Get right. I highly doubt you’ll regret it. 

I’ve been seeing a lot of Step-1 induced panic in my inbox and on my dash over the past few weeks.

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I know some of you are super confident in your own abilities and never express the tiniest bit of doubt and are sure that you’re going to blow Step 1 out of the water. Those of you that fit that description should probably check the Step 1 discussion boards on SDN, start pimping your fellow students, and go ahead and start studying for Step 2.

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The rest of you have some doubts about your abilities to make it through the last week or so of Step 1 studying. Others of you are starting your second year and panicking at the very thought of Step 1 coming soon. So here comes a little advice/encouragement/empathy from someone who’s been there just 4 short years ago (WHAT WAS IT REALLY THAT LONG AGO? HOW OLD AM I?!).

 beyondtheoath:      Mister Rogers says goodbye. x    I needed that.    4894489548964897

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Asker Anonymous Asks:
I have palmar hyperhidrosis and wanna be a dr. I know it sounds silly to worry about but I would get squeamish if my dr constantly had clammy hands. I've tried most everything but surgery but my question is how can I cope with something embarrassing like that and wanting a career that involves lots of contact
wayfaringmd wayfaringmd Said:

You can always claim you just washed your hands and that’s why they’re damp. 

Or use a lot of hand sanitizer - it evaporates and would probably dry your hands some.

Be a surgeon - they wear gloves all the time.

Or a pathologist - their patients are dead and can’t be squeamish.

Or a radiologist - they rarely touch a patient. 

Or a dermatologist - surely they got special creams for that.

Or a super awesome, confident, any-other-kind-of-doctor who just happens to have sweaty palms but doesn’t let a little moisture hold them back from a great career.

How can you ensure that you are going to be a good doctor and I am not talking about bedside manner because that is a given, but dealing with the paralysing fear that your patient could die from something preventable because you didn’t catch it in time or you made a mistake. How can I know that I would I would be up to snuff. I really want to be a doctor and help people get better but I am so scared. - anon

I want to be a doctor, and I’ve wanted to be one ever since I was a child. I don’t want it for the money, but for the opportunity to save lives. I know it’s no easy task and I’m willing to work as hard as possible to achieve it.. But I’m terrified. What if I’m just not good enough to be a doctor? What if I can’t save any lives, and instead, end up taking them? Have you ever had this fear? What helped you know that you’re going into the right field? Any advice? - heroinandotherdrugs

The fear you both speak of is real and present in the mind of every good doctor. Those who don’t have that fear are the ones who end up making careless mistakes. Those without fear stop learning

So how can you know that you won’t make a mistake that hurts someone? 

You can’t. You absolutely can’t know. 

But this is why we go to medical school. We learn TONS of stuff so that we can avoid killing people. And we don’t stop the learning with medical school. We keep learning in residency and out in practice. It’s that continual learning that gives us confidence and comfort in treating even difficult patients. 

Then how can we avoid hurting patients or making big mistakes?

Sometimes we can’t. That’s why they’re called mistakes. Sometimes they’re unavoidable.

But we try to avoid and minimize mistakes by placing checks and balances on our work. Med students and residents are supervised by more senior docs. We practice procedures a hundred times to expose ourselves to possible complications and make differential diagnoses so we don’t get too focused on one diagnosis. We have M&M conferences to review and learn from our previous mistakes so they don’t happen again. 

We do our best to make sure that the fear of screwing up makes us better doctors rather than timid doctors. 

This fear you have can be healthy and productive, leading to personal growth and confidence, or damaging and all-consuming, leading to burnout and crippling insecurity.Those who succeed in medicine make a conscious effort to choose the former. 

It’s up to you which way you go. 

Asker Anonymous Asks:
Hello! Just wanted to comment. I've have used sdn before, but every time I use it, I just end up feeling worse about myself because I don't measure up. I follow you and the other medblrs and all your advice and support makes me feel much more confident about becoming a doctor. Keep up the great work and good luck to all the other doctors-to-be out there :) Not gonna let the gunners shoot me down!
wayfaringmd wayfaringmd Said:

See guys, THIS is what I’m talkin bout.

Asker Anonymous Asks:
I am a few months away from starting med school 3000 miles away from home. I sometimes find myself depressed over not knowing what specialty to pursue, what type of research to pursue, whether I will pass Step 1 or not, being in a lot of debt, and if I will be able to make it through the first few months. This is weird to me because I am normally self-assured and a pretty tough person. How hard should I punch myself in the face to snap out of these negative thoughts?
wayfaringmd wayfaringmd Said:

Stop. 

Remember the pancake analogy of med school? How you gotta eat 5 pancakes a day to keep up? Well right now you’re looking at a truckload of pancakes and understandably freaking out. 

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Stop that.

Focus on today’s pancakes. Just. Today’s. Pancakes. 

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Asker Anonymous Asks:
Thank you for being such an inspiration to all, especially to those who are driven to serve! I am 20 and thinking about being a doctor. But I am really worried about capitalism in the medical field, sleep deprivation and staggering student loans. Can I ask for your advice in terms of dealing w/ them in the future or making an attribution to make sure that they're valid/invalid enough to stop me from pursuing medicine. Thank you!!
wayfaringmd wayfaringmd Said:

ADVICE TO PREMEDS: HOW DO I AVOID LETTING MONEY TROUBLES AND SLEEP DEPRIVATION KEEP ME FROM PURSUING MY DREAM?

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Dear, you have just summed up in one short paragraph the reasons why most of us want to be doctors and the reasons why a lot of us get burned out. 

My grandmother once jokingly told me that maybe I should think of a different career pursuit besides medicine because I like to sleep so much. Fear of debt and sleep deprivation are legitimate, but not reason enough to stop you from pursuing a career where you can potentially have a huge impact.

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If you are going in to medicine with the intention to serve people, you have to be sure that you are constantly reminding yourself of that focus. That’s how you keep the capitalism and student loans from bringing you down. Remember, there are PLENTY of jobs you can have as a doctor that aren’t all about the money (hello family medicine!). You can run a free clinic, be a missionary, run an FQHC clinic, do volunteer medicine, or work with public health. Or you could just be a “regular” kick-butt doc who chooses not to let money control them. 

Loans are for most of us an unfortunate inevitability. I got tons of ‘em and I want to be a broke, hut-living missionary.There are tons of service-oriented programs out there that will pay most or at least part of your loans for you in return for a few years of service in an underserved or rural area. I’m not going to let loans get in the way of me helping and serving patients. And you can’t either. 

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Asker Anonymous Asks:
Hi, wayfaring. I dunno if you can help me but here goes: I'm an MS1 and despite my efforts, I'm at the bottom of my class and barely passing. I've tried switching my study habits, etc, but nothing seems to be helping, and I'm really worried that it's going to affect what residencies I can get into and my board scores. Any suggestions? Maybe I'm just too stupid for med school.
wayfaringmd wayfaringmd Said:

Ok, first of all, if you’re smart enough to get IN medical school, you’re probably smart enough to get THROUGH med school. 

It seems that you’ve already done some work to try to bring your grades up. Try getting some outside help. Talk to your adviser and find out if there is any extra help available to you at your school. And maybe they can suggest some changes for you that you haven’t thought of yet. 

Of course, making it in med school takes more than just smarts. There are a lot of reasons besides intellect why people don’t do well in school. Maybe for you it’s a problem with motivation, or dealing with other life stressors, or burnout, or maybe you’d just rather open a gourmet grilled cheese sammich restaurant / fro-yo joint and be done with medicine (no? just me?).

Many schools have peer counselors available as a first step for dealing with these issues, but they can also recommend professional counselors if you do have issues besides studying that are affecting your performance in school. I HIGHLY recommend you consider if there is anything other than the academic material holding you back, and if so, get some help. 

Ultimately, it’s better to repeat a year or take a year off if you need to than to trudge through and barely get by. Sure, it’s more expensive. It’s not ideal. But barely passing board scores and a match-less Match Day aren’t ideal either. Talk to someone at your school who knows your situation and get some individualized advice.  

I know you guys don’t hear this much, so I just want to let you know I really appreciate y’all taking care of me. My daughter is an MD and I’ve watched how hard she has worked, and I know y’all have all worked that hard too. So thank you.

Rare words of thanks from a patient

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