As someone who is often put in a position to offer advice and as someone who has never shied away from being very open about my own less-than-smooth journey in medicine, I want to share something that happened today with you all. Especially the young ones, who are just starting or have barely started their journey in medicine.
Let me start by saying that I have never been ‘naturally bright’. Every ounce of ‘intelligence’ I have been praised for having was either through titanic amounts of work and tenacity, seeking tutors and friends to help me. A lot of failing and learning from the failure to rise up and improve. So I’m no stranger to the humility and shame of doing poorly, and the important lessons it teaches.
That said, I’m still a human being so I still really hate being wrong or failing. And growing up, failure was not met with kindness. It was met with yelling. A lot of yelling. Yelling that extended beyond the grade itself into unnecessary dissection of my personal faults and decision making. For you see, my parents loved to ‘diagnose’ problems. B- on a test? Must have been because we let you get dinner with your friends. That was a mistake. Didn’t make honors? Why are you crying, you weren’t honors material anyways, you like reading comic books too much to be in the honor roll. Stuff like that. That’s the kind of, ha, encouragement, I received.
So understand that I don’t, at baseline, have a healthy relationship with failure or asking for help. It took me years of therapy, finding good role models, taking to mentors, findings supportive friends and family members to unteach and help me learn better ways to frame the narrative of my failures into stepping stones upon which to build my success. And on the whole, I do pretty well these days.
But today was very disappointing. Already really down from my grandma’s passing, my program director, who is amazing and meant no harm and was wholly pleasant and kind and supportive about the whole thing, asked me to come to her office. She wanted to arrange a time to meet after my grandmother’s funeral to talk about my abysmal in-training exam score and how we could come up with a study schedule together based on my weak areas from the test. It came to no surprise to me that I had tanked the test. I blew through it, not really interested or focused, because I knew that if I didn’t hurry, Lord knew how many consults would be waiting for me. And I had already gotten into the funk I always do with standardized testing: I’m gonna suck at it anyways, why try harder. I can usually lift myself but I was so stressed out, so nervous. So I knew when I got that score back, I’d hate myself for it. I just didn’t think anyone would care enough to notice or point it out.
Initially, when my program director brought it up, I felt like my cover had been blown. Not only was my grade, albeit not a real grade that counted for anything except personal pride, not up to snuff, but also an attending I really admire had mentioned in her eval that she loved my enthusiasm and desire to learn but wanted the program to help me shore up my ‘fund of knowledge’. Shit. I had always known. My medicine program never prioritized my education. What I knew, I had to forage for myself. I think it’s fair to say that most of what I learned in residency was self-taught. So of course, I already felt like an imposter, getting into my dream fellowship, a place I never thought would take a scrappy, foulmouthed internist like myself. I actually recall myself physically wincing when I heard that, although I knew no one would strike me.
Internally, I was a storm of guilt, shame, embarrassment, and self-hate, but also strangely relieved. I felt like a cry for help, no matter how soft, perhaps even one I had been trying to hide for a very long time, had been heard. It was also the first time in a very long time anyone in a position of authority did not ridicule or belittle me for my shortcomings, did not threaten me with the specter of punishment or disappointment, but asked to help me without any trace of pity. She genuinely just wanted to help me do better for myself.
I’ve spent so long in residency depending on myself. Hell, I’d say in life as well. Although an uncomfortable and sad experience, it was also very healing and I felt hopeful. Perhaps this time, as I often have to do, I have to take the long road, the harder road to get to where others get to easily. But I take comfort in knowing that this is the road I always have to travel. I am tired of traveling it, but it’s nothing I can’t do. And I will have some help along the way this time.
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