On training

Residency training and vicarious traumatization

To give a name to something is to acknowledge its existence, to give it a name is to validate its being. I had been through 4 years of rigorous training in a physically and emotionally demanding specialty. I have, at first, decided to embark on it because of the optimistic “vibes” regarding the field – the kind of patients I would manage and the cases I would see—which did not seem to be as depressing compared to other specialties. For one, this field has very few mortalities that to lose a patient is considered a “mortal sin”.

The hopeful optimism of youth – that is the main reason why I chose to dedicate 4 years to delivering babies and taking care of laboring mothers and seeing women with diseases in their reproductive system. I am a female, and what better reason to go into this field than that? No one else can understand my patients’ condition as I do because I have the same XX chromosomes as they have. I will be able to empathize and help them and that would be fulfilling and a worthwhile thing to do everyday.

Somehow, though, disillusionment set in. There were just too many patients and too many demands. On my time, my strength, even my finances. There were days that I literally would dream awake because of lack of sleep. I would snooze standing up, and sometimes even on the operating table! A full day would pass with me going hungry, having missed breakfast, lunch and finally eating a lone dinner at 10 pm because there were just too many things to do. I wouldn’t go home on days on end, and even when I get home, it would be to shower, get a fresh batch of clothes and off I’d go to the hospital again.

I found myself getting easily irritated with my patients. My patience with them, was frayed to the hilt, to say the least. I was abrupt, hurried, unsympathetic. What happened to me? Why do I treat them, these people whom I have vowed to help, like pests and nuisance that I have to get over with. I did many things that I am not proud of. Good clinical practice was sacrificed for expediency – because I was just too tired and too preoccupied with a million and one things.

I can easily say that it was all a traumatic experience. But how can I say that when I have learned so many things as well? There were also times of happiness. A woman grateful for me saving her and her child, that old lady with cancer comforted by me talking with her (in the guise of getting her history), a small child whose abdominal pain was relieved by an operation I’ve done. In the end, do these moments make the whole experience worth it? This is a question I am still grappling with until now. Precious moments with my family and loved ones sacrificed for this training. Precious moments that I could have used to watch a movie, read a nice book (aside from the prescribed clinical texts). In the end, my training defined me. I cannot now be contented with being less than busy. And I have this great urge to always do something important; otherwise I’d go insane. I am grateful for everything I learned. They are just as precious as the things I chose to give up to learn them. But I am only now realizing the enormous cost of that learning, that choice.

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