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A Little Confidence
Alain Irving Le
This piece was previously published in
Annals of Internal Medicine 2005;143:234.
It was the second day of medical school and already we were headed up to the wards to confront our first real patients. With a shaking hand and a similar shake in my voice, I introduced myself as a first-year student. Sitting down in the chair beside my patient, I asked, "So, what brings you to the hospital today?" My inquisition steadily grew as more questions came pouring forth.
"How long has this been bothering you?"
"Is there anything you do that makes the pain better?"
"How has this illness affected your quality of life?"
Five minutes flew by in no time at all. Getting a patient history was a piece of cake, I thought. No sweat! Closing up the interview, I decided to ask my patient a simple question:
"Is there anything else I can do to help you with your stay?"
She replied, "Why, yes."
Wait! This was not going according to plan! In my role-playing activity just ten minutes earlier, my classmate had responded "No" to this same question. Already I could feel little beads of sweat starting to form on my forehead. What would she ask me? What kind of medical procedure could I possibly perform? What in the world could a student on his second day of medical school know that could possibly help any patient out? I was not yet trained to handle anything! I was three months away from studying the coagulation cascade, 12 months from learning the causes of hypoxemia, 25 months from understanding the management of gastrointestinal bleeding. In fact, I did not know medicine at all. Having graduated from college as a business major, I was a clean slate, devoid of medical knowledge.
Not knowing enough in medical school is something that frightens me every time I turn another page in the thousands that make up Cecil's Textbook of Medicine. I find myself repeating the phrases "I do not know" and "I did not know that" countless times a day. There is so much to learn, and I have been told that there will always be someone older and wiser telling me, "You still don't know anything yet." Indeed, it is hard to imagine that one can dedicate his or her entire life to medicine and still not know all there is to know. This is a humbling reality that I am going to have to get used to in this profession.
So there I was, sitting next to my patient bracing for her inevitable question. I realized the only thing that I could do at this point was to reach for something previously untested. Searching deep, I took hold of a little confidence. I was new, but eager, and there would be plenty of time to learn in the years to come. If I did not know the answer to her question, I would hold my head high and tell her that I could look it up or find someone who did know. Being confident in unexpected situations is something I would have to master if I wanted to become a good physician. Thus, I braced myself for the very first question that would test the limits of my medical knowledge. And so the patient asked me:
"Sir, could you turn the television back on when you leave?" |