Medicine: Embrace the Suck?

By: Will Smith of The Lost in PreMed Podcast

“Appreciate the struggle and embrace the suck.”

In the moment, it’s an idea that allows you to climb the large mountain ahead. Retrospectively, it’s a source of motivation; nothing in the future is insurmountable because of what has already been conquered in the past.

I hit an all-time low towards the end of my last rotation. The grind was getting to me. I didn’t really mind the physical aspect of my day pre-rounding, rounding, notes, more rounding; it was tolerable. What was gnawing at me was the mental part.

It’s much easier to push through being physically tired when you feel like you are part of a team. But when your name is “medical student” five weeks into the rotation and you have worked with the same group of people the whole time, the hours become longer and heavier than they once were.

The low point came on a holiday weekend. All of the other medical students on my rotation had the day off, but because it was my partner and I’s normal Q4 day to be on call, we had to come in. Trying to be optimistic, we showed up early and pre-rounded like always. By the time the attending showed up, we were ready to go. My presentations were sound, I gave only pertinent overnight updates and my treatment plans were solid enough to not raise any disapproving eyebrows. On the performance scale, I’d say I was closer to a dragon-glassed Samwell Tarly than I was Tyrion (Targaryan?) Lannister, but hey, better than being an unequivocal Hot Pie, right? (Game of Thrones reference)

After rounds had commenced, the attending lobbed a little appreciation our way, “Thanks for coming in on a holiday. Since the rest of your group has the day off, we will get you out early and you can go home and study or whatever.”

We nodded our heads in appreciation and headed back to the residents’ room to start our notes. Partially through my first note, the senior resident came in and begrudgingly addressed the attending’s last comments. “Well, I guess you guys get to go home after your notes, so split them up between the two of you and let me know when you are done. I’m going to lunch, so text me if anything comes up.” It felt almost like a thinly veiled punishment.

Normally our responsibility was to follow 2-3 patients, write progress notes, make appointments and follow-up on any labs or imaging that needed to be done. For whatever reason, today was different and now half of the floor was mine. The amount of work wasn’t the issue, it was the way it was dropped on us. I bitterly worked through lunch and it made for a very salty afternoon. A whopping 24 minutes before the end of our normal shift, I was finished with my notes and headed towards the subway station. At this point, I was over being frustrated, now I just felt beat down and broken.

Over the next 3 subway stops, I nearly drowned in my own self-pity. Usually, I don’t take things like this too personally but being treated with so little respect made me feel terrible. I’m spending time in a place where I am unappreciated when I could be spending time with my family.

For years I have sacrificed day in and day out, studying into the wee hours of the night in order to get to where I am. But if this is what it’s going to be like, as if I don’t exist at all, I don’t want to do it anymore. It’s just not fair! Just as my inner monologue finished uttering the last sentence, I saw him out of the corner of my eye. With a disapproving look that seemed to pass through me, my inner dark passenger started in…

“Sorry to tell you, cupcake, but neither life nor medicine is fair! Four years ago, you were doing CPR and coding patients at 430 in the morning to help pay the bills, then driving to campus and sitting in an o-chem lecture just a few hours later to finish off med school prerequisites. If “old you” were told that this is where “future you” would end up, “old you” would have gone from o-chem lecture straight to the library and studied for the rest of the day, just to ensure that this reality would come true.

Yes, it sucks to be treated like this, but are you really going to let one person’s piss-poor attitude stand in the way of what you have worked so hard for?

This is why you’ve fought so hard! This is why you’ve had sleepless nights and non-existent weekends! This is why you’ve sacrificed! You are finally where you have fought so hard to be and now you want to quit?!?! Suck. It. Up. Snowflake!”

A moment of pause let the inner lecture sink in. I couldn’t argue with any of what had been said. Perhaps it was a little raw, but that didn’t make it any less relevant. In an act of what seemed like divine intervention, the subway train stopped and the doors slid open. I jumped out of my seat and took two steps forward, only to realize it wasn’t my stop. Feeling like a complete tool, I sat back down; my inner dark passenger rolled his eyes.

I had spent many years working and going to school for what amounted to 18+ hour days, 5-6 days a week. There were times where I was stretched so inconceivably thin that I wasn’t sure I if was going to be able to make it. On a good week, I’d get to see my wife and daughters 3-4 times. On a bad week, family time only happened on the weekends and I was so exhausted I could barely stay awake.

At my lowest, I would always tell myself, “Remember this feeling. One day this is going to pay off!” After saying that over and over for so many years, it started to just sound like a way to talk myself off the ledge. I wasn’t sure if I truly believed it or not. But then, almost a half-decade later, this day happened; my pity-party on the subway.

Sitting in a beat up ol’ train car, I realized for the first time that what I had been telling myself all these years in order to push through my toughest times was more than just a coping mechanism. The relentless pursuit of my dream has brought me to the point where I get to come in on a holiday and write progress notes on half of the patients on the floor for someone who didn’t even appreciate me enough to know my name…because

I AM A MEDICAL STUDENT!

In isolation, it was a crappy situation but put in the context of my struggle to even get into med school, this day was one to be appreciated. In the past, I clung to prospects of the future to get me through difficult times. Now that I’m living that future, I’ve learned how to use the past as a way to show myself that no situation (or person) can get in the way of my dream. I have no control over what the senior resident chooses to make me do, but I do have control over the way I choose to respond.

I chose to embrace the suck.

As it turns out, the next day on rounds, my partner and I were the only ones on the treatment team who knew all the patients on the floor. We were able to make the residents look good in front of the new attending, which is never a bad thing:

(Med Student Lesson # 74: Whenever you have the opportunity to make a resident look good in front of an attending, DO IT!)

Medicine is not an easy path and sometimes you need to dig deep, appreciate the struggle, and yes sometimes, even embrace the suck.

Will Smith is a medical student and aspiring Emergency Medicine physician. He is also the creator and host of The Lost In PreMed Podcast, a podcast geared towards PreMed students. You can follow him on Twitter – @LostInPreMed.

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