A View from Internship

From the 7/31/2020 newsletter

A View from Internship

Kim Tyler, MD, MS

Dr. Tyler, who recently graduated from medical school, shares her thoughts on developing a professional identity even as medicine goes through the upheaval of a pandemic …

Starting my intern year during a pandemic is not what I had in mind a year ago when I was preparing residency applications. I could never have anticipated what this first month of internal medicine residency would be like. I find myself thinking multiple times each day, “I should not be allowed to do this.” “Who decided that I was qualified to do this?!” “It is wild that they let me do this.” There is a constant tension between what I feel is expected of me and what I feel is within my abilities. I wrestle with “Impostor Syndrome.”

The first time a patient called me their “doctor,” for example, I nearly fell over. The first time I was summoned to pronounce a patient’s time of death, I stared at my pager wondering if they’d contacted the wrong person. A few weeks out of medical school, “doctor” is an identity I have not yet learned to accept.

As I move through my days, I experience twinges of incompetence. I fear that a patient might call me out. Of course, this is a familiar theme for many during the pandemic. None of us has the faintest idea where this is headed, and uncertainty lingers over all of healthcare. When the ICU fellow is questioned by a family member about treatment options for a COVID patient, does she feel the same doubt that I feel? Do even the most confident attendings have moments of distress? Perhaps some who have made careers out of medicine are being reminded of how they felt when they first started—now challenged by an illness in whose face previous medical knowledge seems inadequate. Is there, in this moment, an opportunity for all of us to acknowledge our hidden feelings of inadequacy and hesitation?

Sensing what it means to be a physician

Even though I am new to this, I believe I am starting to sense what it means to be a physician. In the quiet moments after a patient has confided a fear, a hidden addiction, or a smothering depression, I realize I am accompanying them on their journey. Even as I struggle to enter home healthcare orders, sort out conflicting lab results, or work through admission orders, there are times when I allow myself to just stop and be present in the spaces I inhabit with my patients. The specter of this pandemic highlights the importance of sitting with suffering even when we cannot relieve it.

Even in this time of great uncertainty – and in the midst of my first weeks as a doctor – I can see the beauty in simply and generously being present.

Kim Tyler, MD MS is graduate of the Medical College of Wisconsin Class of 2020. She is currently a PGY1 in the MCW Internal Medicine residency program.