During the second semester of my second year of medical school, I took a course in Pharmacology. It was one of the tougher courses for me, because I felt I was just practicing rote memorization and wasn't yet able to relate drugs to diseases they treated. Part of the course designed to help with that was a few group sessions with a "patient simulator". Basically, this would consist of a group of 4 medical students huddling around a mannequin (who talked and had bodily functions), trying to figure out what was wrong with it. There were always attendings standing in the room watching your every move and, I thought, just enjoying watching you sweat.
My first patient simulation turned out to be a diagnosis of Atrial Fibrillation. This is a condition where the heart gets a little "irritable", so to speak, and decides to beat really fast in an irregular rhythm. This is bad because the irregular rhythm causes blood to pool in the heart, which can cause a clot, which can then travel to the brain and result in a stroke. I had a very vague and minimal understanding of this disease at the time, but I did know that it would require anti-coagulation to keep the patient from clotting (like Coumadin).
After the simulation was over, the attending decided to ask all of us questions (aka "pimp" us) to make sure we understood the diagnosis and treatment. After a few minutes of this he turned to me and said, "so what medication does this person need to be on"?? I sheepishly said. "Coumadin?" and probably turned eight shades of red. The attending had no expression on his face, looked down at the floor, and responded with, "So you want to give your patient RAT POISON?!?! How do you explain that??" **(Note, Coumadin originally was used as rat poison because it caused them to hemorrhage internally. In smaller doses in humans, it counteracts clotting).
I was crushed. I thought to myself: I must have said a stupid answer! I thought I knew that! I'm so embarrassed! How will I ever be a good doctor if I want to give my patients rat poison?!? I fought back tears until I was in the car, and then was really bummed out for probably three days afterward. I thought i was going to be a terrible doctor. I didn't know at the time that he was just trying to make me be confident in my (correct!) answer.
Now.
Flash forward to today. I'm a soon-to-be-graduating fourth year medical student working in the Medical ICU. I'm past my pharmacology days and this month have been helping care for the sickest patients in the hospital. This week marks the third week of my rotation, and also a schedule change in attendings. Well, who do you think walks in to teach on our team, but that same attending from my second year pharmacology simulation! I hadn't worked with him (or thought too much about him) since that semi-traumatic moment a few years back. I got a little nervous.
After our team finished rounds, the attending wanted to give us a short lecture on mechanical ventilators. We went to the conference room and I listened to, well, one of the best lectures I've heard in all my four years! We reviewed anatomy, physiology, pathology, and treatment all in one session, and it made sense, too! We had open discussion about related topics, and even though some of my thoughts were wrong, I wasn't embarrassed. I learned a lot, and this guy will now go down in my book as one of the best teachers I've encountered at South.
So, what changed? I'm pretty sure it wasn't the attending. Nor did I grew exponentially smarter (though I wish that were the case). I think it all comes down to having more confidence. Confidence in myself as a future physician, and confidence simply in my ability to think. To trust in my education thus far and not resort to feeling like I've failed if I get an answer wrong. Because, I will definitely get answers wrong. Yes, I've learned a lot of anatomy and physiology and memorized a few drugs over the past few years, but I think one of the best things my medical education has given me is confidence in myself and my abilities.
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