By: Jessica Petrovich, MD
I am writing this from a lakeside somewhere outside of Monticello, Utah – aka, the middle of nowhere. So far, the second year of residency has been hectic, with plenty of late night call shift emergencies and (mis)adventures navigating our awesome interns through their first tumultuous month at Salt Lake Regional Hospital. Admittedly, I had been looking forward to being shipped out to the southeast corner of Utah for my rural rotation this month. It’s no less of an adventure, but I do get a little more time to myself for reflection as I admire this amazing state that I now call home. Here, I’ve been spending my weekdays stretching the scope of my abilities as a family physician as broadly as they can go (literally everything from birthing babies to treating heart attacks in the emergency room) and spending my weekends getting lost hiking in the expansive canyons that go on for miles. As I reflect upon my training as a family physician, I realize that there have been a lot of moments where I have felt unnerved, out of my element, and a bit like a scared kid on a roller coaster ride that just won’t stop. After regularly submerging myself into a wide variety of work environments over the last six years, I can see how my response to the discomfort has shifted over time.
There is a lot of pressure in medical training (and just school in general) to know everything before you’ve even started your career. In the beginning of my training as a medical student, I made the common mistake of smiling and nodding while residents rattled off their long-winded differential diagnoses that I had never even heard of. I didn’t ask what “pneumotosis intestinalis” meant on the CT scan report and I just hoped that someone else would bring it up first so that I wouldn’t have to look stupid. After years in a row of being out of my element and always the learner, I know better than that now. I heard a Maya Angelou quote at the beginning of my intern year that became my residency mantra which I now share with my fellow learners in hopes that they will not be ashamed to admit their knowledge gaps as I once was: “Forgive yourself for not knowing what you didn’t know before you learned it.” It’s a reminder to myself to have some self-compassion in the learning process. As far as I can tell, the only way to learn everything you need to know as a physician is to be humble and genuinely curious in the moments where you feel like the most inexperienced person in the room.
I used to dream that someday I would be able to slide gracefully through a day at the hospital without ever having to hastily look something up. It turns out that the expectations of my own brain capacity were a tad unrealistic. I remember when I first started working at Salt Lake Regional Hospital last year. As the “downtown” hospital, a large majority of our patients are homeless or have substance use disorders. I’d never heard of “red devils” and I had no idea the many creative routes in which you can get amphetamines into your bloodstream. My life got a lot easier when I learned the simple phrase, “I don’t know a lot about that, can you explain it to me?” I learned this lesson again during my international rotation in Guatemala this year. I definitely took at least a week’s worth of cold showers before I finally asked my host grandma to re-explain how to use the “widow maker” attached to the shower head. Looking back, I should have just saved myself the shivering and admitted that I didn’t understand her the first time. Hopefully, all of this vulnerability in uncomfortable situations is making me a better doctor and a better learner.
As a family physician, my knowledge base can be as broad as I’ll allow it to be. There is no limit as to what can walk through those clinic or hospital doors. When I’m done internally panicking over the fact that I don’t know the “right” answer off the top of my head, I actually really enjoy the extreme variety and daily learning that my job provides. From street names of common over-the-counter medications to language barriers in clinic, I know that I have plenty of uncharted waters ahead of me. Life-long learning is about fighting that natural urge to be complacent and regularly pushing your own boundaries. It’s terrifying and exhilarating all at the same time and it’s exactly the life I want.
Jessica Petrovich, MD, is a second-year resident in the Division on Family Medicine housed in the Department of Family and Preventive Medicine at the University of Utah.