On the clinical grind (or the cost of earned knowledge)

The glamour of last week, the beginning of clinical rotations, has worn off. Now, the fatigue settles in and I’ve already found myself wishing for no-show patients. I only need to see one or two patients in a morning, not the primary care marathon of a patient every fifteen minutes for the entire day, every day of the week.

The chaos of clinic is constant and irregular. A simple and straightforward annual health maintenance visit for a second year pharmacy student might trip up a brain fart. A patient with a complicated medical and social history might take up almost an hour of my time, but I can confidently recommend resources and practices that would relieve some of their burdens. I might help an 18mo old with their fear of white coats and needles or I might talk enthusiastically about Brazilian Jiu-Jitsu with an ICU nurse. Or, I might just spend the afternoon crushing flashcards and shooting the shit with fellow students. The days are predictably unpredictable.

Last week, I sat for a weekly quiz, this one on the subject of Endocrinology, and scored a 75%. This week, I scored a 12% on Infectious Diseases. A solid reminder that my studies do not begin and end with the clinic doors. For these first weeks, my mission has been to settle into a sustainable routine and maintain a semblance of a self-care regimen. So far, so good. Now, I need to fold dedicated studying time into the mix, as flipping the occasional flashcard and completing the rare question block is not sufficient for the clinical expectations.

Life will not stop nor slow down just because I’m tired and the day at clinic drained my reserve of energy. A simple disagreement might result in an overflow of emotions and stress because of unfortunate timing. When I wear the white coat, things can roll off my back. Once I’m home and in my comfortable shorts, then I’m vulnerable to human experiences once again.

I’ve maintained some self-care routines and ignored others. Once a week floats are something that I anticipate greatly. I have not been moving as regularly as I would like, sweating rarely but with great relish. The long hours of standing have resulted in an astounding amount of tension in my calves and hips. My traps are a mess of knots because of few chances during the day to lay down and rest my neck.

The stress of clinic is quite real. The third year lifestyle takes its toll and I notice the lack of vibrance from some of the students in the class above mine. Their clinical knowledge has come at the cost of vigor and their own personal health. I fear this trade. I know that it is necessary and inevitable in some sense: the system demands a sacrifice. The MD letters are earned and not given.

I simply hope that I can retain enough of myself so that I can recognize myself at the end of this challenging year.


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