Secret Doctor: Developing a thick skin is essential in life, more so as a medical student

A life of on-call shifts, handovers, and on-going learning. A junior doctor who has worked in Ireland and overseas looks at life as a medical student and as a graduate. Over the next few weeks, they will compare their experience of Irish hospitals with medical work in the southern hemisphere

The Secret Doctor

With trembling anticipation, I crossed the threshold of the hospital's main entrance, a place I hadn't set foot in for nearly 10 years. 

Back in my student days, I roamed these corridors alongside my comrades, indulging in lengthy lunches at the canteen. 

Mandatory hospital placements were an integral part of our medical education. 

The first half of our degree involved immersing ourselves in theory-based learning, while the second half was predominantly spent on hospital placements. 

These placements required us to ingratiate ourselves, learn, assist, and, most importantly, obtain that coveted signature confirming our attendance by the end of the week.

During my time as a medical student, I was often mercilessly ignored, sometimes I was acknowledged but very rarely was I welcomed. 

Unfortunately, this plight is all too common for medical students. 

We were expected to be ever-present for any fleeting opportunity to learn, while simultaneously behaving as benign wallflowers, avoiding any intrusion or mere existence that could disrupt the delicate balance of hospital routines.

A particular highlight or lowlight depending on your viewpoint was when I was joining a ward round - daily rituals where every patient is seen by a doctor; often led by consultants, and the length of review is very user-dependent - as a student, I was braced for the learning opportunity, standing keenly at the bedside with everyone else, when the curtain was appropriately closed to offer some semblance of privacy to the patient (albeit somewhat limited in a standard 6-bed shared hospital room). 

However, the curtain was purposely closed in front of me, excluding me from the review. Developing a thick skin is essential in life, existing as a medical student hastens the rate of thickening.

After graduating, my initial months as an intern were dominated by stress and anxiety. I yearned to make a lasting impression, to provide exceptional care, and to demonstrate competence. 

Yet, achieving these goals seemed like an arduous task within the confines of my own mind. 

I think back to the ward I was on when a drug chart, a clinical record where all medications are prescribed for a patient within a hospital,  was handed to me — a momentous occasion was to unfold — my very first medication prescription. 

How exciting... what am I entrusted to prescribe?… paracetamol… I have been entrusted to prescribe a medication that can be picked off the shelves in the local supermarket.

Reality hit me like a sledgehammer. Basic tasks became a significant part of my daily workload. 

I vividly remember an incident during those early days when I was inserting an intravenous line, known as a cannula, only to realise I had forgotten the connector that closes it off. 

Suddenly, there I was, with a large cannula inserted into a vein, but lacking the crucial connector within arm's reach. The ensuing scene resembled a crime scene, with copious amounts of blood splattered on the patient's clothes, my own attire, and the surrounding area. 

Naturally, I profusely apologised, applied the missing connector, and swiftly departed from the scene of the accident, cleaning up as best I could.

It quickly became evident that, at the start of my career, I could only be entrusted with limited responsibilities — and rightly so. 

The heroic aspirations I once harbored were unattainable. I swiftly learned that my role primarily involved performing basic procedures (while skillfully avoiding any murder scenes), devising efficient task plans, requesting tests, and completing paperwork. 

I adapted and carried out my duties to the best of my abilities. Working as an intern felt purposeful; I genuinely believed I was contributing to the functioning of our healthcare service. 

The sense of teamwork was strong, and I finally felt like I was firmly behind the curtain, metaphorically speaking.

The next time I was to return to this institution was with a sick family member a number of years later. 

Despite looking after thousands of patients and communicating with countless families, I was the one sitting in the waiting room, priming myself for better news than was received. 

It was during this time that I was torn between my identities of giver and receiver of medical care. 

I entrusted the care of the wellbeing of my loved one to the hospital and it gripped me with fear. 

I knew too much of the goings on in the hospital, so was on edge throughout the next week. 

This person was cared for wonderfully and made an excellent recovery — however, I gained a new understanding of the anguish of those at home waiting for an update, a phonecall, or any signal of reassurance.

Since leaving this institution I have worked in 12 additional hospitals, I have moved through various parts of Ireland, and worked abroad. 

Our training requires that we regularly move to learn from different mentors and in different services. I have gained so much experience and competencies.

The insecurities I once harboured as a new intern have long passed. I walk through this hospital with confidence in my abilities. 

I have become the person who advises, guides, and reassures. 

I pick up the phone and reach out to families. I am still completing my training and I will continue to learn and gain experience for the rest of my career! 

Despite how my career has progressed I will always remember the feeling of a curtain being pulled in front of me and continually try to include students, allied health professionals, nurses, families — and, most importantly, my patients.