I had a girl with "chest pain" as the chief complaint as my last patient before exiting the ED tonight. It really made me think how far I had come and how much more experience I've had in the few months that I've been a "doctor". As I walked into see this patient, I walked in with an interpreter and a student, confidently I took control of the situation, slowly dissecting the history to reveal what was causing her problem. Quickly ruling out the serious causes and pairing it down to only a few unconcerning possibilities. As my diagnosis became more clear the plan seemed to logically follow from it to get an electrocardiogram and a chest x-ray to rule out the unlikely but serious problems and have her follow up with her pediatrician for what likely were panic attacks. Not to say that I've suddenly become this genius in the past few months, but I've become much more confident in my logic and my decisions. That patient 3 months ago would have freaked me out. I would have stuttered my way through the history/physical exam, likely missing a lot because of nerves...and then I would have followed that up by serving up a half-baked plan to my attending (and I definately couldn't have done it with a student under my wing).
Now I find myself actually telling (very politely ;P) the attending what I'm going to do, where before I would "suggest" my plan. It's really a good feeling to see myself growing into the shoes that seem so big at times. There are moments when I'm walking by my hospital, when I gaze up at the tower that houses the patients. My hospital is expanding. Right next to the old tower is this shiny, new one...that is about 4 times as big as the old hospital. Looking at the two side by side, the leap of moving from that "small" hospital to a hospital that will be one of the largest in the country (maybe the largest) is daunting...that's how I feel when I look at myself in comparison to just the 2nd year residents (let alone full blown Attendings)...such big shoes to fill and I'll be expected to fill them sooner than I'd like. It comforts me though to remember those two hospitals, the difference between the two may be overwhelming, but my small, old hospital won't suddenly become that new, big one in a single night...it will grow into it one room at a time, one step at a time...until one day months, maybe years, later it will finally become that thing which it has for so long aspired to be.
Newbie Doc
