I’m Here to Learn

The sharp, staccato beeps shock me sharply from the hazy semi-sleep I typically entered during these nights.

Call.

I quickly reached for the sound, desperate to silence it and keep it from reaching my family’s ears. As I did so, I could feel the familiar rush of cortisol already beginning to make my heart beat a little faster, fanning my anxiety about what awaited me.

A patient in the emergency room?

An unstable patient on the floor?

A critical lab value?

A child at home with a fever?

How quickly my mind flashed through the possibilities!

I pressed a few buttons in my bleary-eyed state until I reached the right one and the message flashed.

“Heart rate in the 30s.”

My own heart rate increased a little more as I rapidly dialed the call-back number with one hand while pulling on my scrubs with the other. I ensured the patient was stable, asked for an EKG and got in my car to see him for myself. As I drove, I couldn’t help but wish my mind would come up with answers as quickly as it came up with questions—a thought I’ve had at least a million times since starting residency. It’s 1 am, but shouldn’t my brain know I’m a resident? That I need it to function a little faster right now?

No.

Not faster.

More skillfully.

And I was once again reminded of the mantra I’d chosen for this phase of life called residency. The phrase that has been pulling me up and through this process: “I’m not here to be brilliant. I’m here to learn, to take care of patients, and to be a part of a team.” It just so happened that right then, I had the charge of all three.

I’m not here to be brilliant.

As I arrived on the floor, I found the nurse and was handed an EKG. I found myself craving the certainty of a test question: a few choices—one certainly correct and several incorrect, and the satisfaction of definitively knowing the answer or crossing off the incorrect choices. However, this was real life with a real human and a real heart that was beating just a few times too slow over the past minute. Instead of five choices, I quickly compiled at least 20. Which one to choose?

I’m here to learn.

I craved the knowledge of a fellowship-trained, widely and deeply experienced attending in cardiology. Surely that physician would know what to do with a slow heart in the middle of night. I envisioned a physician confidently striding into the hospital and calmly evaluating the patient, competently voicing orders to an attentive support staff audience. Instead, I caught a glimpse of myself in the glass of one of those ubiquitous hospital reprint paintings: wrinkled cerulean blue scrubs, glasses that I wore on call to hide the bags under my eyes. The seasoned nurse turned to her charting, totally unflappable.

I’m here to take care of patients and to be a part of a team.

What if I make a mistake? What if he comes to harm, and I miss something obvious, and it’s all my fault? It’s my responsibility to take care of him and this slow heart… and, I quickly realized, the nurse, the attending, the support staff: we were all, in our own way, responsible for this patient and his heart. I wasn’t taking care of him. We were taking care of him.

At the reminder of the mantra, I felt the breath I didn’t know I’d been holding release—a reminder to take another fuller, deeper, breath. My fears being addressed one by one. Another inhale, another exhale and I could feel the gears turning, the breath like oil for my tired brain. The dust began to fall from my memories and a coherent assessment began to form. The patient had received a higher dose of a beta-blocker medication, but was otherwise stable, asymptomatic, and without changes on his EKG. The nurse agreed to make sure the pacer pads were nearby (at my insistence and her amusement). I called the attending with a brief update. To my relief, she agreed with my assessment and plan. I collapsed on the call room futon, wincing a little as my back hit the frame where the stuffing had grown thin. As I stared at the fluorescent lights, I felt humbled, and far from brilliant, by the experience of the past hour.

I’m not here to be brilliant.

I’m here to learn,

To take care of patients,

To be a part of team.

The weight of each phrase sank in a little deeper as I lived the experience they spoke of. A few hours later, I handed off the pager and went home to brush my teeth, find breakfast, and get dressed for a morning of clinic, feeling maybe just a little bit wiser.