About an hour or so before every shift, I feel this weight in the pit of my stomach. It's an odd feeling.
It reminded me of the time I went skydiving and looked out the hatch I was going to step out of. I was going to jump out of a perfectly functioning plane.
Madness. What was I doing.
But it was also different. With the skydiving experience, a rush came over me and said "YEAAA LET'S DO THIS". With this feeling, I feel more paralyzed. I look at my car keys and hospital ID badge on the table and I'm frozen to my chair.
I put the feeling out of my head. I have another 30 minutes before I have to leave anyway. And then, when it's time to leave - I don't have time to think about it.
Time to go! Or I'm going to be late!
And so I run out the door, trying to ignore that heavy feeling in the bottom of my belly. The heaviness in my legs as I step through the door knowing I'm now fully committed to getting to my shift and doing things. Things that'll hopefully make people better.
In retrospect (and after typing all of that) I guess it's simple to see what they feeling was. Maybe it was that I didn't want to know what it was. Because once you know, it becomes more real. You become more aware of it.
(If you don't know who Judge Dredd is, boy. You are missing out on some fantastic comics and movies!)
What the hell am I doing. Sure I've got almost a year of residency training and a few more years before that from Medical school. But do I really know what I'm doing? Kind of. I get better every day but you're never perfect. No one is. Especially when you're in a field that is equal bit art as it is science.
I didn't fully understand what was going on till I read an article by a world renowned neurosurgeon. I encourage you to read it as well if you have the time.
He describes it very eloquently as the weight of decision making. In his case, often life altering decisions. And he talks about how the uncertainty is so gripping. Even a small wrong move can spell doom.
He calls it a sense of doom. I call it a sense of dread.
In his article, he points out that the sense of doom gets stowed when the rush of taking care of a patient kicks in. In part, I've noticed that too. Although I feel I'm more like a headless chicken running around - regardless - my sense of dread gets stowed as well. A welcome feeling.
The odd thing I've noticed? The more I understand my sense of dread, the more I understand how little I know / how much I need to learn (and sometimes, the only true way to do this is by sheer experience rather than book knowledge), the more dreadful it gets. The heavier my stomach feels. Or maybe it's just because I know it's there so it feels heavier.
It's never paralyzing dread. Hopefully this feeling evolves into something that fuels me to be better rather than mutating into a paralyzing fear. I also don't want to become someone who loses that sense of dread. Because going numb is never the answer.
Regardless, what helps me push through my dread is reminding myself of the Hippocratic oath's cornerstone: "First - do no harm". This, coincidentally, also happens to be the neurosurgeon's article.
Do the best I can, in good faith, and always - try to do no harm.
In other news: I'm almost-not-an-intern anymore! Yippe!