The Pressure Cooker

My training prepared me for a lot of things.  Some of them were not so good.  When you train in medicine, you learn to be under pressure much of the time.  I was in medical school from 1978-82, and in my internal medicine residency from 1982-85.  That era in the medical education field is not known for its attention to the stress levels of the trainees.  It predates the movement to limit the number of hours students and house staff can work, something that has since become a mainstream position, resulting in binding rules to that effect.  It also predated the idea that stress was something to be avoided, or at least managed.  No one was sitting around looking at the amount of stress we were under and calculating how to minimize it.  There was little attention to the fact that the stresses we talked about with our patients might be affecting us ten-fold, and causing the same diseases and life reactions that we cautioned our patients about preventing.  

 

When I view that time period in retrospect, I can pick out a number of instances when  those attitudes prevailed.  An example is when a fellow intern developed a heart arrhythmia.  She was examined in the office that the residents used on our hospital floor.  As word spread that she wouldn’t be able to take call that night, several other interns came to see her and look at her electrocardiogram, checking for themselves to see if their own increased workload was justified.  Instead of being sent to an appropriate treatment area and given rest and sympathy, she was treated with a chorus of “Are you sure the atrial fibrillation is still there?” and “You’re not working tonight?!” 

 

Another episode:  I was a fairly capable and efficient intern, having come from a medical school that valued clinical work and gave us plenty of experience as junior and senior medical students.  I could take in patients from the emergency room, push them through the subterranean tunnels of the hospital, and load them into the elevator to come upstairs to a hospital room, and simultaneously take a history from the poor soul on the stretcher.  Once we arrived at a room, I had to perform a thorough physical and then collect blood and urine specimens which I examined in the lab myself.  If there were other procedures needed for the patient, such as IVs or joint fluid extractions, those were also done by me.  This went on over and over again on a call night, admitting one patient after another and performing the evaluation to determine what was wrong and what needed to be done.  I recall a night when I reached ten admissions, an astronomical number of patients to admit and work up.  My conversation with the resident in charge included his verbal pat on the head for me, acknowledging that I “could handle it.”  I was proud.  I did not question the fact that I was being asked to perform back-breaking work on no sleep, and that it might not be good for my health or the well-being of the patient. 

 

It was rumored that one of the women who began internship with me that year tried to commit suicide within a month of our July orientation.  She quietly disappeared from the program.  There was no discussion of the event, no evaluation of the rest of us to see if perhaps it was the program and not the intern that needed fixing.  I think the general concensus among the housestaff was that she was wimpy, inadequate, poorly prepared.  God help us, we were ignorant.

 

I say all of this because I have experienced a recurrent problem since that time of rigorous, crazy training.  I see large, monstrous tasks of questionable worth and herculean work requirements and run towards them.  I feel pressured to have a challenge in my life.  I fight to make things harder, longer, more painful.  Even though I recognize this now, and can forcefully change my reaction, my knee-jerk response is to embrace stress.  This doesn’t go well with a diagnosis of lupus, or with a healthy emotional life. 

 

Tonight I clicked on a new blog and the word “contest” leapt out at me.  It was a store blog, and they were seeking to sell large amounts of a gorgeous, expensive (and notably quite fine) yarn by sponsoring a design contest.  The entry requirement was to purchase their yarn ($46 a hank) and design a beautiful piece of lacework with it.  Now I love design, and I have learned much from entering contests, but I’ve never done any knitted lacework.  I actually paused for thirteen minutes to consider whether I could teach myself enough about lace and practice hard enough to produce a professional appearing garment by mid-May.  Now that I have backed away from it, the word “insane” comes to mind.  I don’t need an excuse to buy that yarn.  I can have it if I want it.  I can learn to knit lace – I was talking to a fellow knitter about that today, as a matter of fact.  But why would I want to jump into a situation where there is time pressure and judgment riding on it? 

 

The answer is in my training.  While I learned a lot, and became a good doc in the process, I also learned some bad things, and I have to continue to fight against them.  At least I recognize it.  At least I said “No” to this challenge.  Deep breaths…

 

Peace.

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One Response

  1. I am so interested in your knitting projects. The process of knitting the socks is fascinating. I haven’t knitted much and find myself working every stitch ever so carefully. I do have some friends who knit that I can fall back on their advice and assistance if needed. I can crochet anything, including lace. I’ve been working on my knitting lately and, although a challenge, am thoroughly enjoying it.

    I happened on a book of crochet patterns with some stunning sweaters and I’ll be looking forward to making them when I have my own yarn spun. My new wheel will be here on Monday if we don’t get another 2′ of snow. We’ve had over 30′ so far.

    Take care………

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