My wife and I were in a unique situation after graduating medical school. We had met in the first year of medical school in and became friends. During our second year we started dating, and by end of third year, we were married. By the beginning of fourth year, we were proudly expecting. By June 1st, 2016 we were fortunate enough to share our graduation from medical school with our family we well as our one-month-old son at our side. That day we had no clue of the obstacles we would face, not only as new physicians entering a brutal intern year but as new parents.
For those not familiar with the first year of residency, regardless of specialty, the time dedication is grueling. My wife and I had matched into separate family medicine residencies in Arizona. Both residencies had approximately 10 months of inpatient medicine with one to two months being a combination of nights and/or clinic. The hospital medicine portion was 6 a.m. to at least 6 p.m. — six days per week. Depending on the service, time often exceeded those limits. Despite this commitment, we felt confident we could work together to overcome the obstacle of work and caring for a newborn.
Just as intern year started, the year was over. Although we have not had much time to reflect on the year, we knew how far we had come as physicians, a married couple and parents. We calculated out that we each worked on average 74 hours a week, ranging from 60 hours to 98 hours. We reflected how fortunate we were having such supportive family members and residency staff. Without the help of family and the people around us, we would have had a more difficult time. There are many things we learned throughout the year, but none more important than the core values that tied our profession, our marriage, and parenthood together.
1. Each day is a new day, be present. In medicine, like many careers, it is easy to take emotional baggage home. As new physicians learn to evaluate patients, it can be easy to take the emotional toll with you from one patient to another. Throughout the year I learned how important it was to not only treat each day as a new day but each patient as a new patient. If you bring negative aspects from a bad day or interaction with you, the domino effect can be catastrophic by the end. Each day my wife and I learned to talk about our day, our ups, our downs and everything in between. Before seeing a new patient, I learned how important it was to take a deep breath before each encounter. The idea of being present was especially challenging coming home to an infant after a 12 hour day. All he wanted was his parents (mostly his mom) to snuggle him while he rolled or crawled on the ground. Spending time together as a family was the best part of my day. I learned how creating a blank slate was vital to surviving parenthood and intern year.
2. Teamwork. Learning to navigate the ins and outs of the hospital as an intern can be a steep learning curve. In a residency where one rotates in different specialties throughout the hospital, it is especially important to be able to rely on your co-residents and support staff. Each new rotation is a lesson on how important teamwork is. From the nurses and co-residents to the phlebotomists and respiratory therapists, everyone has an important job to make the patient experience as safe as possible. When you carry those virtues to your home life, things have a tendency to run a lot smoother. My wife and I were exhausted every day after work. But with the support of our family, friends and each other we were able to get through each day and still have time for our family. This is not to say we did not have our ups and downs, but there were key points to remember: there is no task that is below your pay grade, and ‘dirty diaper changer’ should be the primary job of the person not providing the food.
3. Learn to be comfortable with vulnerability and limitations. One of the most valuable lessons I learned through intern year was never to be afraid of asking for help. Often, especially as new physicians, it is easy to feel vulnerable when one doesn’t know something. When someone comes to us asking for help, we want to be able to reassure as well as educate. As new physicians, it can be easy to feel insecure when we are already managing the idea of taking care of patients on our own for the first time. On top of being a new parent, this notion was augmented for us in particular. Battling insecurity can be difficult. The important thing we reminded ourselves each day was the support that we had. From our co-residents and attending physicians to our family and friends, we felt fortunate that we were never afraid to ask for help.
4. The sweet is never as sweet without the bitter. Too often, I hear parents express disdain for the infant months and look forward to when they are “more fun” at one year of age. Due to our career paths, it was even more important we share duties that were taxing and exhausting. For example, I cannot stand doing laundry. Luckily, my wife does not like doing dishes which makes us such a great team around the house. But sometimes we cannot get away from the chores we don’t like, and they have to get done. This idea also relates to medicine. Of course, it would be ideal to have every patient compliant, educated and not consistently readmitted to the hospital. These cases can be mentally taxing. But all it takes is one patient, staff member, colleague to say, “Thank you.” Whether it is a late night at home, or at work, there is nothing more satisfying knowing you took part in something bigger than yourself.
No matter where you are in your life, intern year is hell. And no matter how difficult intern year can be, the single most important thing to remember is — you are not alone. Spend time with friends and loved ones, watch the show you have been putting off and understand that no matter what, it gets better.
Matthew Steele is a family medicine resident.
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