This Resident Roundup post comes from Sean Pirkle, MD, a third-year resident with the Department of Orthopaedics and Sports Medicine at the University of Washington, Seattle.
I just woke up. It is 3 a.m. in October, and the autumn air is cold. The chill has snuck into the leather of my car seats as if it were hunting me in the dark, in between states of consciousness. My eyes are nearly plastered shut, contacts still in, and I try to revive them with the few drops of saline that I keep in my jacket pocket for instances such as this, before driving off to another hospital 20 minutes away.
If I could just survive this week, then everything would be OK. If I could just make it to the next day off, then my apartment would no longer be a disaster and I could find time to respond to the mountain of emails in my inbox and log all of the cases I have been neglecting. If I could just endure this 28-hour call shift, close my eyes in my car for just a couple of minutes, then the morning would be that much closer, and I would finally be able to get some actual rest. Most days during residency, I find myself in this cycle of wanting to run out the clock.
This mindset is nothing new; it is almost as if I am falling back into old habits. For years, I sacrificed my todays in search of a better tomorrow, pinching my nose as I swallowed lost weekends and missed weddings and proximity to family, telling myself that it would be worth it in the end. Now that I am here as a resident, I reflexively wish away the days, trying to keep my head above water. On this mindless drive between hospitals with my sleep interrupted yet again by the pager, it is hard to not feel isolated—from my wife who is asleep at home, from my parents 2,500 miles away, from the 18-year-old version of myself who dreamed of becoming a doctor.
The last patient I saw was a teenager with a distal radial fracture. His dad was worried, and I let him stay in the room for the reduction, something that I typically do not do. We made small talk and I learned about the choices that moved him to the Seattle area, his other children, and his career at a biotechnology startup. When the procedure was over, he kept gushing about how fascinating it was, this job of ours. After a few minutes, his son turned toward him and asked, “Are you thinking about switching fields?” to which he laughed and said, “No, I don’t want to be here at 2 in the morning.”
If given the opportunity, I know with conviction that the younger version of myself would focus on the beauty in the last consult, the privilege of meeting a patient at their most vulnerable, helping them feel heard, and reducing their distal radius safely and effectively. My younger self would choose to be unbothered by the burden of being awake at 2 in the morning, driving like a lunatic between hospitals, and would instead slow down and look around and focus on the positives—that he made it to his version of tomorrow. If I told him where we were now, I know he would smile. That doesn’t make the work hours less grueling or the tedium of charting disappear, but when I reflect on how far I have come to make it to this career that I have chosen, it is hard to not find gratitude. At a certain point, my tomorrows started to become my todays, and old habits must die in order to find joy in the present state of being because there are moments to be thankful for in nearly every facet of this job. Sometimes it just requires a little extra searching.
And so on the rest of this drive, what is left of it, I’ll choose to roll down the windows, play some music, and maybe even sing a little.
Sean Pirkle, MD
Dr. Pirkle is a previous contributor to Resident Roundup. Read his recent essay Dear Future Consult Resident.
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