What the Mind Does Not Know…An Introduction to
My first day of internship was actually a night. Before the start of the official year, there was an opportunity to cover the various hospitals in our system so that the other residents could go to the graduation celebration. Over the phone, even before I arrived in New Jersey to begin my internship, I volunteered.
The night of my call, coat neatly pressed and internally terrified, I meandered over to the hospital and wandered around until I could find food—and eventually—the senior resident.
There weren’t a lot of instructions for this endeavor. We met the senior, a tall lanky guy whose mind appeared halfway out the door already.
“You’ll do fine.” He said. “Just call if you have questions, do the admissions as they come. You’re senior is here for you if you need them.” That was it. He departed and we were left to wander through what would be our first taste of medicine.
For some reason, I’ve never liked how this story goes. I, as a second born, observant by nature kid was never a fan of surprises. I still don’t care for them to this day. I prefer my birthday presents ahead of time. I read the back few pages of novels first. I hate traveling that involves “winging it”. There’s a closet type-A crazy, control freak inside the type-B candy coated shell. And this is just one of his isms. I like to prepare, to pre-think, and know ahead of time what I should have in my repertoire.
As I’ve progressed through my medical career, I’ve kept that lens and I continue to view the world through it. Most events, issues, and problems that I’ve encounter that make life hard for us have tells. They have a prodrome. Even if they don’t other experiences can signal the underlying system or mechanisms at work that lead to these problems.
It’s not just in medicine either. Life is very similar.
For most of us, we went through school in somewhat of a straight shot, give or take a few years. This was the dream since we were a zygote and we’re finally out of school and into seeing and treating real patients. We have a niche. We have a place. And the day you become an intern, you realized, or should have, that you have a responsibility. To yourself and to those you serve.
I remember in my internship one night where, when checking on a patient in follow-up I realized she was not doing well. I’ve come to call her particular style of breathing gagonal. The gasping, agonal breathing of pending respiratory failure. When the acidity of the blood begins to auto-fire the medullary breathing center. There result is a choppy abrupt fish gulping phenomenon that can support the bare existence but not much else. And for next five minutes, that patient’s life, and the help she would or would not receive, lay in my hands.
She died that night. But not before I was able to rouse the team and get her emergently sent to the OR. I had a small job that night. Check. That’s it. Just check on them and follow up. But life and death where in that word. But something helped me that night. By then I had acquired a few guideposts, a few rules to live by. One of which, was take care of people.
You see, the issue that night was that my senior on the service had seen the patient. And the service I was on was not the kindest collection of folks I’ve met in life. There was a hesitancy, while it seems silly now, that was very real and stood at odds against doing the right thing. But take care of people doesn’t care what I’m feeling at the time. It’s always right. And it always tells you what to do.
You don’t think it will, but in the trenches, things get murky. Simple things get hard to see clearly. You have conflicting stressors that war against you and against each other. In medical school you see this second hand. You watch the interns and residents wade through the ambuguity. But then the story becomes first person. It becomes your reality. And the sum of it is, you need to prepare for it.
That’s the heart and soul behind LifeRounds. Its a collection of lenses to see this world through. The right lens can make all the difference. It can filter the noise and help make things very clear and very easy to navigate. We call this by a different phrasing in medicine. What the mind does not know the eyes will not see. Perception changes when we filter it.
So here’s the honest truth of the matter. Some of these lenses will be life changing. Some intuitive. Some seem bland until enough life experience passes and those experience unlock the power of these principles. They’re meant to be read. To be shared. Pondered and discussed. Their meant to be torn apart and chewed on until all the sap of their truth is exposed.
They can help you be a better intern. They can help you be a great resident. And, with the right attitude, they can help you be a great doctor.
And that, after all, was the dream.