One foot in front of the other

‘So, what do you want to be when you grow up?’

Such goes the line commonly said to the children starting prep. It’s a question that often invites the very first considerations about identity and one’s place in this big, wide world. This line is also said to another very particular breed of children – doctors. It’s a question, that when asked to a doctor, invites and then evokes a particular idea of what said doctor must be like, based on a lot of pre-conceived ideas and a little bit of gut instinct. Are you the kind geriatrician who is keenly invested in a descriptive bowel chart? Are you the smiley paediatrician who has very little interest in how an adult works? Or are you the surgeon in the room?

I think we nurture a particular idea of what kind of doctor we want to be when we grow up, even from medical school. It’s this identity that slowly gets carved out, bit by bit. Shaped by not just seminal events in our developing careers, but also by our day to day working lives. The first successful cannula after several failed ones. The daily coffee with the people you end up spending all your time with. The referral where you managed to not get yelled at by cardiology. It's the little things, really. Like anything that is well worth shaping, sometimes it’s bits and pieces that slowly start to come together without us fully realising over the course of the year. And so as another clinical year comes to an end, I’ve been thinking more and more about these bits and pieces. But because it should never just be about the medicine, I’d like to also share my slow journey back into running. Running and dancing and movement were my first solid connections into feeling grounded and letting go of the mental fragments that sometimes float untethered.

It can be easy to become fixated on the kilometres ticking by on the smartwatch. The datapoints of pace and rhythm. What the data doesn’t show, however, is how distinct the skyline looks when peppered purple and pink, the pressing need for some kind of a sugar hit or how fixated one can become on simply stopping. The perseveration of ‘I can’t go on any longer’ is rhythmic as one foot goes in front of the other and then beads of sweat remind you of this bodily experience that you actually chose yourself. And then somehow you’ve made it. Sometimes medicine feels like this.

At a point during my surgical term this year, I found myself hiding in a supply closet. Not to cry (surprisingly) but because a space amongst the camboots and crutches seemed like the only quiet spot where I could sit down to make the phone call to tell someone that their person had died. In medical school, they try to teach you a few things about breaking bad news. It involves something about always having a box of tissues at the ready and ensuring that you are uninterrupted in a quiet area. I strongly suspect the person who wrote this type of curriculum has never carried a medical pager. So, there I was, perched fairly precariously on a 4-wheel frame balancing a blue folder trying to find a phone number and trying to piece together a story. I actually think it was the first time I had slowed down that day. It was so still. And completely ridiculous that I was in an equipment room about to talk about something so important because it was probably the only place I could do so uninterrupted.

I think I learned a few things from that day. Firstly, 4-wheel frames have brakes installed for good reason. Secondly, what you prioritise in your day not only reflects on the demands of your unit but also what you value as important. And I guess I still think it’s important to sometimes talk to people and give them a little bit of your time. This might be an unpopular notion in the busy, rush-rush-rush mentality of today but there is a small joy in being able to demonstrate your care in an uninterrupted fashion, even if it’s just for 5 minutes. We celebrate the hardships of this job far too much. A part of it reflects the deeply caring nature of the people doing this, and how hard a fragile system can push us. It’s the unheroic stuff: the intense sensation of dehydration, the extremely vague idea of the last time you peed, the lingering sensation of the things you’ve held on to that you felt didn’t warrant enough to handover.

And yet we still try to learn from all this, and from each other. Within our various training pathways and within a system that is frail and fraught with shortcomings and throughout the course of what sometimes feels like a very long clinical year. I suspect a part of it is because at the end of the day we just want to hope that we were enough. Someone once told me that medicine is the marathon that you have to sprint. So whether you’ve jogged at a leisurely pace or felt like you were running up a hill this year, I hope that you still found little pockets of joy on the way. I think at the end of a long clinical year what we all ultimately wish for is some sense of accomplishment. Maybe it's that exam you finally passed. Maybe it's the registrar year where you finally found your stride. Or maybe it's just that you managed to find your balance on a 4-wheel frame for long enough to be fully present for an important conversation. All of it matters, even when the learning can feel fragmented and imprecise at times, I hope that you realise that it all eventually does come together, even when it may not feel like it, all in time for the beginning of a new clinical year.

As for the question about growing up? Not anytime soon.