Dreading Clinic?

I knew heading into the last 10 weeks before graduation that I would be working with one of the most difficult attendings on campus. I had heard of classmates going home crying after clinic because of how they stupid they felt, like they weren’t enough, like they shouldn’t be there.

 

After one day working with him, I felt the same. I didn’t cry, but I did feel grossly inadequate in my skills, in my thinking, in everything I did with regards to clinic. And that sense of low self-worth was affecting my other clinic days. Where I had gone in confident in my skills and thought processes, I was now second guessing every single thing I was doing.

 

Looking back, I can see why that doctor did what he did. In his own way, he was pushing us to stand up for why we were doing what we were doing. He wasn’t questioning us just to make us feel stupid. He was questioning us to make sure we had the right foundation and mentality to approach clinical care, to point out where our gaps were and make sure we recognized them too.

 

At the time though, it certainly didn’t feel like that, and I dreaded that one day a week working with him. Each week, I mentally kept track of how many more times I’d have to endure the mental humiliation and discouraging comments. I suffered through it and just sucked it up until the session passed, knowing after graduation, I’d no longer have to work with him.

 

I wish that I had a better coping mechanism then. This was before the importance of mental health was more globally recognized. This was also before I knew how to better stand up for myself and vocalize my needs, before I knew how to articulate that this was not a conducive way to my learning, especially with just weeks left before graduation.

 

So when one of my recent students came to me saying her next rotation was at a clinic she was not looking forward to, I had to stop her and ask her why – because I did not want her to follow in my footsteps of just sucking it in, going to clinic to do what she needed to do, and not get the most of her learning and education.

 

We both knew she’d be getting a lot out of the clinic she was going to. It was another community clinic where the population would challenge her understanding of systemic health and its connection to the eyes and vision. We knew she’d be challenged by the language barriers of that population, with the increased difficulty of being able to get the information she needed to do her exam and convey the results and appropriate management in a way the patient could understand. And like me, she’d be ending her spring before graduation with an attending whose energy she knew she didn’t match well with.

 

So I gave her these tips as a way to center and refocus. I suggested that she get a bottle of essential oils that calmed and soothed her and smell that each day before she left her car to go into clinic as a way to ground her and calm her down before the craziness of clinic started. If she didn’t want to do that, I suggested she write down her why for what got her motivated in pursuing optometry in the first place – to help other people – and keep that reference close and handy whenever she started losing her motivation and confidence in clinic. If she didn’t want to do, I suggested she find some other inspirational quote or prayer to put on repeat in her head and focus on that when she was feeling low. I don’t know what, if any, of these methods she chose to do, but in the end, she graduated and is now working in the real world.

 

The point of this though was to find out what way or ways are best for you to keep you going when the days are rough. If you’re facing waves of exams or boards coming up, or attendings or clinics that are outside your comfort level, or patients or colleagues who push your buttons, it’s good to have some tools ready to get you centered and focused.

 

Put together that playlist of feel good, upbeat music. Have that list of inspirational quotes ready for motivation. Keep that essential oil or crystal or touchstone close at hand.

 

Start building that toolbox now so that when you need it later on, you don’t get lost in the overwhelm and start heading down a downward spiral that’s really hard to get out of.

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