Today I was called "doctor," and that was scary

I'll repeat: Today I was called "doctor," and that was scary. Now I do know I still have a few blog posts in the queue (no worries, they'll be up this weekend), but I needed to write about today before my brain started its evening purge. I took notes after several patient encounters because I knew I had to put pen to paper (or, is it "fingers to keyboard"?). The past few hours have been a bit of a shock to my system: "Hey doc, I've been waiting for you. You mind throwing a few more meds my way?" "Oh, it's so good to see you, Doctor, we've been waiting! I have a couple questions for you if that's okay?"

No no no no no. I'm just a medical student! I have no idea what I'm doing! Don't ask me anything; I'm clueless! And, are you ready for this? Today's my first day! That makes it even worse!

I think it's the white coat or the tie. Maybe it's the stethoscope or my Surgery Recall tucked deep into my coat pocket. Perhaps it's the notebook and the gloves and the scissors. I just know it can't be me. There's no way I look the part. Shadow of a goatee or not, my clothing and tools of the trade might look professional, but my badge says "student" (and my eyes say, "What did I get myself into!?"). Today I was hit by the brutal reality and awesome responsibility of my future profession: when I walk into a patient's room, I'm going to be instantly trusted. Maybe not by every patient, but for the majority of cases, that white coat means a ton. It means that I'm trained, I'm learned, my opinion is founded on years of scientific knowledge. It means that I am the front line of defense against all harm, and sometimes death. And it also means that as a caregiver, I do just that - I give care. My responsibility is both scientific and humanitarian. All because I put on this white coat. Perhaps that job description is oversimplified and broad, but my new responsibility is both simple and profound: when I wear the badge of my profession, there is no escaping symbolism.

I didn't understand this in the first two years (I say that even though it was just yesterday I became a third year!), probably because every time we students were in the hospital, we shuffled into a tiny room by the dozens and were immediately introduced as "medical students." During community weeks, the line was less defined. But it was clear that students were part of the normal practice, and our role was mostly confined to taking a history and doing a brief physical exam (plus I never wore a white coat in clinic - it scared the kids). Today, however, five patients were assigned to me. I spent the afternoon reading their charts and meeting a couple of them, so when I walk into tomorrow morning at 0600, I can pre-round, write their overnight progress notes, present to my attending on rounds at 0800, and continue to monitor them throughout the day. I'm there to help change wound dressings and answer simple questions. I can hold hands and make small talk. I'm part of their care team now. I am part of their lives.

All because I put on a white coat this morning.

Actually meeting the patients was the easy part. The hard part is knowing where to go, where to be, how do I write a note, do I write an official note actually in the patient's chart (the answer is "yes"), where do I get scrubs, how do I scrub in, where do I stand, is my patient presentation format right, am I working this weekend, am I on call, what does this beeper do, what if it beeps, am I allowed to eat food from the physicians' lounge, what is a PSBO ("partial small bowel obstruction"), if I don't know the answer does that make me an idiot, does everybody else get these questions wrong, how long will it take to pre-round on five patients, how much of a physical exam do I do, am I asking too many questions, am I asking too many questions, how should I study for the SHELF exam...

You know, just little stuff like that.

In the grand scheme of things, it was a very short day. I didn't have to wake up early, and I was done after lecture around 1730 (see, I can use military time now!). But, mentally it was taxing. This will take some getting used to, I think. I'm putting so much emotion into everything right now that I was drained by the end of today. Goal: I need to tone down my emotional output, without getting emotionally detached. There's just so much learning to do. It's not just the medicine I need to learn, but how everything works. How to study, how to learn, how to relax, how to exercise, how to eat... how to care. Basically I'm relearning everything, start to finish. Today was Day One of the rest of my life. It's going to be a lot of work; there are going to be a lot of ups and downs. It's going to be tough, and it could be fun. Who knows what tomorrow will bring, but I think I can face it.

Today I was called "doctor," and that was scary. But I think everything's going to be okay.