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Stanford University School of Medicine

“As a new doctor, you will…” — A senior resident shares her experience

Usually we just dash through life, accumulating disparate bits of wisdom but rarely taking the time to assemble our hard-won lessons into anything cohesive, much less anything that could benefit anyone else. But when someone does take the time to offer advice, it's usually well worth a look.

That's how I feel about a recent essay by Ilana Yurkiewicz, MD, a senior resident in internal medicine at Stanford.

Her advice comes in the form of a series of vignettes, each beginning with the phrase: "As a new doctor, you will..." Some will make you smile. A few are quite sad. And taken together, they might even spur you to start studying for the MCAT, or to remind you why you originally went into medicine.

A sample:

As a new doctor, you will make the wrong prognosis. I'm on call in the intensive care unit. All day I have been going back and forth with the attending physician about a 92-year-old woman with heart failure. Her breathing is slowing, the level of carbon dioxide in her blood is rising, and she's falling into a deep sleep. She doesn't want any artificial ventilation, and I'm running out of options. Shortly after 10 p.m., the attending tells me that I did my best, and I realize: This is what dying looks like.

I gather my patient's sons. 'I'm worried that your mother won't survive the night. If there's anyone she would want to see, I recommend you call them now.' Grandchildren, neighbors, nieces, nephews, and friends trickle in at midnight. They form a tight circle around her bedside, whispering loving words until the sun comes up. The following morning, she is slathering jam on a slice of toast. 'How are you?' I ask dumbly. 'I'm fine, dear,' she replies. 'And you?' Our conversations are similar every morning until the day she goes home.

Learn more about Yurkiewicz' saves and slip-ups, her lying patients and her dying patients in the full piece.

Previously: "You can do anything for four weeks": Advice for clerkships, "We are a team": Advice for new residents from chief residents, in their own words and Advice for young docs from psychiatrist David Spiegel: Find a mentor and pursue your passion
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