Breaking in the New Shoes

This weekend has been all about breaking in the new running shoes. As much as I love the feel of worn-out ripped running shoes that have faithfully served me over 100s of miles, I finally decided it was time to start the cycle again with a new pair. So, I laced up my new shiny, silver, white and turquoise shoes and broke them in this weekend with some long runs to the beach.

Yesterday, I made my way through Goldengate Park to Ocean Beach up to the Cliffhouse. Today, I followed the same path and went farther up to Land's End. With the sun shining over my shoulder, I took in the scenes and sites of a familiar running trial with all of it's climbing, descending and incredible views of nature and water. I have to say running (along with friends and family) has gotten me through my first two years (and now my third year) of medical school.

As I run, I always take time to reflect and think, mentally sorting the loose ends of my life- everything from pondering about existential thoughts (what is the meaning of life) to thinking about my personal life (how can I make time for my friends and family given such limited time with rotations) to thinking about my professional trajectory (I have so much distance to go before I feel like a real doctor).



It's interesting how we sometimes seek escape from thinking of anything medical the moment we leave the clinic or hospital. But our minds have a way of redirecting us back. As I ran, I started thinking more about my inpatient medicine rotation and my past patients and experiences-- the moments of triumph in taking care of patients and the many moments of defeat in coming to terms with the reality that we are students at the bottom of this immense hierarchy.

We are surrounded by other long white coats and members of large teams that march around the hospital, rounding on patients. Despite being part of this team, we can't help but feel alone in our lack of knowledge on many fronts. The culture of each field is initially foreign to the nomadic student, who has to quickly adapt to a new environment every eight weeks.

We never know what to say (everything sounds significant at first), or how be efficient with our words. We stumble through our long-winded presentations (we have yet to understand the "pertinents"), talk to fast, take up way too much precious time, ask too many questions and know nothing.

Third year is about learning. But how do you balance learning with the pressure of being evaluated based on your performance. It's almost like you're always on a stage, constantly being watched. And the feedback overflows. Constantly being told how you can improve definitely chips away at your sense of self-security, or makes you more insensitive to any type of feedback. I have interacted with classmates that have either valued or completely disregarded the feedback. I'm in the middle. At a certain point, you reach your threshold and decide how to process the critique; I run.

The process of becoming a doctor is truly a unique experience. Despite the inherent challenges, students are privileged to be working directly with patients in their times of need. In truth, memories of my patients stay with me; my patients have been the best teachers. In managing their diseases and learning about their lives, I have learned far more than any lecture, physician or textbook could teach. At times, you relate more to your patients (rather than the long white coat you are supposed to become), as your patient turns to you for guidance in medical decisions, addressing you as his or her "Doctor." The small moments of triumph carry you afloat during the tumultuous waves of third year (and probably beyond)...

You learn to pick your battles and decide how to focus your energy. From Day 1, I knew my focus will always be the patient. Third year is about learning. Sometimes, I have to repeat that to myself (a maantra to remind oneself to find a higher meaning in a somewhat unstructured and difficult year).

***


As I ran and watched the waves crash, I looked at the depht of the ocean and directed my focus to the life around me- surfers emerging from the ocean, runners, tourists. I quickly stopped and looked at the deep blue water. I could only think about one thing- what an incredible view. I took one more look, and with a deep breath in- I picked up my feet and start running again to fully break in my new shoes.