As I drove to my first shift of residency, my first shift as a doctor, all I could think about was my friend’s dog.
During my last year of medical school, my husband had moved to a different city for reasons related to his work. One perk of our arrangement was that he shared an apartment with a friend who owned a feisty little terrier named Barney.
Barney understood only Italian, his owner’s native language. He was not neutered, and he peed aggressively somewhere along nearly every block that we passed during the long walks we took together whenever I visited. He forced his way into our bedroom at inopportune times, wagging his stubby tail insistently and delivering one of the many tennis balls that were always underfoot. Every time we left the apartment, he fixed us with his studiously sad gaze, and he jumped in circles and barked with glee each time we returned.
One Friday night late in the spring of that last year of school, I arrived in the city early enough for a dinner out with my husband, his roommate, and a few other friends. We lingered over our sushi, and by the time we strolled home it was close to midnight. Barney greeted us with his usual fervor and then my husband and I headed down the hall to our section of the apartment.
I took the bathroom first, fishing out the toothbrush and soap that I kept stashed in the medicine cabinet. Over the running water I heard my name called. At first I ignored it, slightly irritated by the lack of privacy that my husband and his roommate had established.
Then another voice called, one of the others who had accompanied us upstairs. “Becky?” Its higher pitch carried clearly through the hallway. “We need you. It’s Barney.”
In the living room, they were crouched on the floor around him. He lay on his back, his legs twitching.
“Is it a seizure? Or a heart thing?” His owner spoke without turning away from his dog.
Despite his personality and antics, Barney was not a young dog. He had a heart condition and a murmur that was clear even to my own newbie ears. But he took daily medications – buried in a dollop of peanut butter – and other than a ban on swimming in his favorite pond, there had as yet been no tangible effects on his daily life.
I don’t know what it is, I thought first. Could it be a seizure? Mere months from graduation, I had never seen a seizure, and certainly had never seen one in a dog. I had read plenty, had attended lectures about them, even answered exam questions on the topic, but these left me with no visceral experience upon which to draw. Weren’t seizures big, dramatic affairs? Surely something more than these low-amplitude shakes?
I asked questions. How had they found him? How had it started? In the background some small part of my mind regained control and murmured louder and louder, It’s a seizure, this must be what a seizure looks like.
“It’s a seizure,” I finally said, trying to keep my voice from trailing up in uncertainty. “It isn’t his heart, it’s a seizure.”
We were all quiet for a moment. Barney continued to shake. Then my friend turned to me.
“What do we do, Doctor?”
I looked up to protest, wondering perversely if he might be joking. Several months still stood between me and my degree. But in his eyes I saw deep fear and a plea for help. To him, a few cushy electives meant nothing. To him, I was a doctor.
I fumbled through more of what I had studied but had yet to truly know. If we were in a hospital, I would ask for Ativan – I think that’s the first drug to use. But there’s no Ativan here. What do you do for a seizure that’s not in a hospital? Idon’tknowIdon’tknowIdon’tknow.
“Is there an animal hospital with an emergency room nearby?” I asked.
But he’s a grad student, half of my brain shouted. A trip to the emergency room will take half the night and cost hundreds. And the seizure may break on its own.
And what if it doesn’t? screamed the other half. I recalled that some resolved without medication, but how long did it take? How long should I wait?
Then, finally, one defining thought: This is Barney. Don’t make the wrong call.
“Let’s go,” I said.
I rolled to my feet and Barney’s legs stilled. Gently, his owner eased him onto his side and stroked his head, murmuring softly. I fell back to my knees, stroking Barney’s side, feeling comfort in the smooth rise and fall of his belly beneath my hand. He remained still, eyes glazed and unfocused for a few more minutes before he became himself once more.
It had been easy to go along with the big deal that was made about becoming a doctor. Just days before starting residency, at a wedding of a fellow graduate, the proud parents had invited all of the freshly-minted MDs out onto the dance floor for a group photo. The banquet hall had erupted in applause.
I felt confident as long as things remained abstract, as long as I focused on the already-accomplished in place of the yet-to-come. Yes, I had studied for four years, rotated with clinical teams throughout the hospital, earned good grades and a residency of my choice. But I had reached the end, and there was still so much I had not seen or heard or touched.
Yet somehow I was a doctor. And now I would be called upon to do doctorly things, to diagnose and choose treatments and respond in emergencies. And I was terrified.
Standing on that dance floor, I had let myself feel confident. Away from my new coat and badge, I had breathed freely in the belief that with time I would learn what I had yet to know. But as I drove toward the hospital for my first night in my new role, all I could see were Barney’s shaking legs and his owner’s pleading eyes. I took a deep breath and continued to drive.
2 thoughts on “The New Doctor”
I am glad there are doctors out there with such clear introspection. Good for you for keeping on driving.
In residency, as you add the practical to the abstract, keep on the look out for times when it is not only you that don’t know the obvious thing to do but the attending and the specialist don’t either. There will always be things that we don’t know but can learn, from a book or a mentor; but there are also problems medicine does not have an answer for. There will always be judgement calls.
The biggest thing to learn in residency is what needs attention NOW and what can wait for further deliberation.
Bobby, thank you for your very kind comment and for your advice. It’s very insightful and something that I will certainly keep in mind as I continue my training.