Emotional Baggage

What’s the Difference?

This week I am on my vascular surgery rotation.  I chose to do this rotation for one specific reason: I love one of our (female) vascular surgeons.  I don’t have a particular interest in varicose veins or diabetic foot ulcers. However, this one woman is so excited and passionate about her job and she loves to teach junior learners that I decided that I needed to do this for my surgery selective.  I have been working with this one physician all week and while I’ve been learning a lot about vascular surgery, I have been learning so much more about myself: specifically, my self-esteem and confidence.

In clinic on Monday, I saw quite a few patients on my own.  With that responsibility comes many opportunities to ask the wrong questions, to forget to ask the important questions, to not know the answers to questions, and to make the wrong treatment or investigation plan for the patient.  But you know what? That’s all okay because I’m still learning and that’s how we learn.  With this physician, I was okay with being wrong or saying “I don’t know.”  I was happy to have her correct me on my mistakes because then I didn’t make the same mistake again. I came away from the clinic knowing more than I did when I arrived.  I had a great day and I felt great about every aspect of my interactions with my preceptor.

In the operating room yesterday, I was grilled on vascular anatomy. Sadly, I didn’t remember very much about vascular anatomy so I did a lot of guessing and answered with a lot of “I don’t remember…”  And to my surprise, it didn’t matter; my preceptor just went ahead and told me the answers and she didn’t judge me or scold me for not knowing.  In addition, my surgical assisting technique was corrected many times, and my suturing was slow even though I was doing a good job.  Despite all that, I felt like I had a great day in the OR.  I chatted with my preceptor as she watched me slowly close the incisions and I wasn’t nervous that she was watching me.  I knew I was doing it right and I felt comfortable and confident working with her.  We did a lot of joking around and chatting about small, inconsequential things in our lives and despite the difference in age and level of training, we had a really great time together.

Never once in the last three days have I worried that my preceptor didn’t like me or thought that I was a bad student.  I know that she doesn’t expect me to know everything and do it all right. And, I know she expects that I am there to learn and that I will get better at what I do as my time with her progresses.  So, why don’t I have this attitude with some of my other preceptors… or maybe even my mentors?  Maybe just one person in particular???

Obviously, I am confident; otherwise, I wouldn’t have moments like I am having this week.  Obviously, I am a good student and I know where my limits are and that it is okay to not know the answer to everything.  Clearly, my self-esteem isn’t that bad if I can have positive, meaningful, and rewarding experiences in a learning environment with other preceptors.  So, what’s my problem when I’m with K?

In almost every situation I find myself in as a medical student, I am confident being the learner and I usually feel like I do a good job of that.  I do what my preceptors ask of me and when I don’t know the answer, I’m not afraid to admit it.  I will search out the answers to the things I don’t know and I will always learn from the experience.  There is always one situation, however, where this is not the case.  I wish I could say it was like that for some legitimate reason, like the preceptor sucks, or it’s a subject that I really, really hate.  However, those reasons could not be further from the truth when it comes to K.

I know what the reason is: with one person, I have tied so much of my self-worth, self-esteem, and confidence to her approval of me.  Not only do I seek out her approval, but I fear that anything I do wrong will result in rejection.  I know it is stupid and unrealistic and unhealthy, but I don’t know how to change it. At least not quickly, anyway.  I need to find a way to interact with K in the same way that I interact with the preceptor I have this week.  I need to walk away from every encounter, with every preceptor, feeling like I am doing a good job.  Clearly, I am capable of doing that – I just need to extend it to all aspects of my life.

I know that throughout the rest of my training, there will be many times when I don’t feel confident with myself or feel that I’m doing a good job.  I think that comes with the territory of being a medical student and then a medical resident.  However, I have to really work hard and be extremely cognizant of when something is a real reflection of me and my capabilities or when it is an unhealthy, mentally imposed self-judgement of myself.  Obviously, I will always be more critical of myself in situations where it matters most to me, such as in my chosen field of speciality.  And, the same goes for if I’m working with people in that field.  Being self critical and self aware is good most of the time – until you take it too far, that is.

Ultimately, there is no difference between how I work and interact with all my preceptors.  If anything, I work harder and I study more in my own field of interest.  By default, then, I would probably make a better impression on my preceptors in O&G than, in vascular surgery, lets say.  So, while there is no difference with the preceptors, I have to realize that there should be no difference with me: I am the same confident, hard-working, well-respected student regardless of who I work with.


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