The Roller Coaster of Residency

This Resident Roundup post comes from Dr. Roohi Reddy, who is a final-year resident in the Department of Orthopedics at the Kamineni Institute of Medical Sciences in Telangana, India.

I believe that things happen for a reason. Although I may not always know the reason, I tell myself that every experience I have—positive or negative—is meant to teach me something. That being said, I should also mention that it can be challenging to believe this, particularly during stressful experiences.

In my first year of residency, the first blunder that I made was failing to look for distal pulses in the case of a supracondylar humeral fracture, in spite of doing a so-called “thorough” examination. It wasn’t until my senior came to examine the patient that we noticed that there was no pulse. It’s hard to get over the shame I felt about such an obvious mistake. How did I miss something so vital? I told myself that I could learn to do better, even if I wasn’t so sure at the time.

Not long after, I had another patient, an elderly gentleman with a proximal humeral fracture. He was scheduled for surgery, but on the day of the procedure, it was found that he had an unstable heart arrhythmia. While his insurance would cover the surgery, not having the surgery at this point would mean that he would have to pay for his hospital stay so far. As I broke this news to him and his family, I felt despair as I saw the resignation in their faces. Could I have done anything differently for this patient? Probably not. Yet I remember wishing that I could do more.

A third patient comes to mind: a patient with polytrauma who underwent 3 surgeries successfully before succumbing to the fourth. I will forever be haunted by her face as she took her last breath just as she was being shifted onto the stretcher after extubation. This was her last surgery and she was doing so well. I spent days wondering if anything could have been done differently. Her unexpected death taught me that things can go wrong even when you think that you’ve done everything right.

Even as I remember these cases, I also think about the times when I felt sufficient, like just a little belief in myself was all I needed. Moments where I felt like I can do it. Like when I reduced my first anterior shoulder dislocation on my own, when I reduced a posterior elbow dislocation, or when I nursed a severe wound to a beautiful and well-healed scar.

Today, as I near the end of my residency, I tell my impatient self that I shouldn’t have compared myself to that surgeon who was much more experienced. I shouldn’t worry about not always knowing the answer right. I shouldn’t worry about the kind of doctor I am, or the kind of doctor that I am capable of being. I can see that, for each time spent worrying, there are more times when I’ve felt like I made a difference. Often, just showing up is the key. Through my roller coaster of emotions, I have reached a point where the way forward is to believe that it’ll get easier tomorrow.

When I look back, I see all the lonely nights I spent doubting myself when I didn’t get the same marks as my peers. I see the insecurity that consumed me when I didn’t know what to do or what came next. I guess that was what I was supposed to feel at that point, as part of the process of learning and refining who I am.

When my junior recently asked me if I thought residency in orthopaedics was the right choice, I couldn’t help but take a moment to think. Even though there were days that were tough and I felt incompetent, there were also days when I could not contain my excitement to assist in the OR. Days when I felt proud of the minutest accomplishments and days when I could not wait to get back to work. I could not get enough.

And the more I get to learn, the more I recognize that I’m probably right where I’m supposed to be.

Dr. Roohi Reddy

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