The Difficult Classmate

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During my first rotation, Surgery, I didn’t work with another student for the entire eight weeks. I spent a lot of time beating myself up, wondering if I was doing the right things and if I should have been doing more. I was excited when I got my Peds schedule which had me teamed up with various students throughout our eight week rotation. Unfortunately, my first two weeks on the inpatient service began sourly due to a negative interaction with a classmate and someone who I thought was a good friend.

I’ve heard horror stories of medical students “gunning,” or trying to make oneself look better at the expense of dragging other students down. Even though I had already heard some unsavory stories about classmates this year, I decided, up front, not to blindly believe or fall into the gossip, especially since I don’t know many people in my new class. I like to and choose to see the best in people, and I refuse to believe that as future doctors with the common goal of caring for patients in the most compassionate and painless way possible, we wouldn’t help each other become the best doctors we can be. Maybe it’s naïve and optimistic, but providing and learning how to provide exemplary care absolutely takes priority over “looking good” or getting the best grades.

That’s why I was so troubled when another student on my service confronted me that she felt I was acting out of place. The patient she had been following was being discharged that day, and our senior resident asked who wanted to complete the patient’s discharge paperwork. I made (what I thought was) an encouraging look her way, as if to say, “You’ve gotten to know this patient and his family. Please, continue to work with them!” She, instead, expressed anger that I had assigned her work to do. That it was not my place to do so. That it was the senior resident’s job to tell us what to do. That she would never do that to me.

I was appalled that my seemingly considerate action could be so misconstrued! I quickly apologized, trying to explain that it was not my intention at all, and that, if anything, I thought I was being proactive and ensuring that I wouldn’t take on tasks concerning her own patient. Interrupting me, she rolled her eyes, angrily saying, “No, you are wrong,” as she turned and walked away from me, my cut-off words of apology and explanation dissolving into thin air.

I later approached her to ask if I could speak with her. After much resistance to a conversation (like, really?), I explained to her my gratitude that she had brought up the issue with me, my apologies that I had hurt her, and my promise to try to avoid making anyone feel the way that I had made her feel. I also told her about my own sadness and frustration that she hadn’t been receptive to my feelings about and perspective on the situation. I felt like what should have been a discussion of how we could ameliorate and avoid the situation in the future became a litany of things I had done wrong, things that were not meant to be malicious, as she implied.

As an introvert who absolutely hates confrontation and conflict, I was proud that I had asserted myself and my feelings in an uncomfortable situation. My heart still pounds thinking about it! I wish I could say that my bravery and sincerity in trying to smooth over a simple misunderstanding was well received, but instead, I left frustrated, with her last words ringing in my head: “I’ve wanted to be a pediatrician for 15 years.” As if that was an excuse for her attitude towards me.

I spent the long, awkward remainder of my time working with her walking on eggshells, trying not to offend her. I was hyperaware of everything I did, every word I said. I second guessed my actions, afraid that it would be misinterpreted. I tried extra hard to make amends, delivering heartfelt, legitimate congratulations when she did well on her oral presentation to the attending and asking her about her weekend. But anything and everything I did seemed to irritate her. And this still seems to be the case almost two months later.

This sucky circumstance has made me realize a few things:

1) The situation is totally out of my hands, and if she doesn’t have the desire or capacity to forgive me and move on, there is nothing I can do to change her mind.

2)  I don’t need to go out of my way to impress people or try to get them to like me. Obviously, being rude is never the answer, but I don’t need to bend over backwards for anyone and everyone I meet, especially if they have only demonstrated the opposite of kindness to me themselves.

3) There’s always going to be people in the workplace and in life that we just don’t mesh with. Maintaining professionalism within a team is essential for it to function at its highest (and happiest!) level. When a problem does arise, we have to be pros at learning how to address, solve, and diffuse a problem, all without compromising patient care. It can be uncomfortable to assert yourself and sometimes even demand that you be heard out, but if it will help you function better as a member of the team, it’s important. Your attitude affects everyone else on the team, for better or for worse. A happy and in sync team will better be able to provide better care to our patients, and that’s what it’s all about!

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Watch What You Put in Your Mouth!

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I rarely eat at the hospital’s cafeteria because making your own food is 1) generally healthier (I also don’t trust myself to make the healthiest choices after not eating for hours, which can often be the case), and 2) cheaper .

Coming off a long weekend at home, I hadn’t had time to run to the store for groceries and I was on call Tuesday night, so between class and meeting the residents for sign-out to the other residents on night float, I settled for a quick chicken sandwich in the caf. Or rather, the chicken sandwich of doom. Within two and a half hours, I asked to be excused home, was throwing up, and, with stomach pains like I had never experienced before, regretting that seemingly innocent dinner decision.

Ah, the joys of food poisoning. The laundry list of symptoms: nausea! vomiting! abdominal pain! diarrhea! fever! headaches! Lucky me, I had it all! Which made me think, gee, I should share what’s going on in my life with the blogging world. Or at least share some more about food poisoning, something that affects an estimated 48 million of us each year.

There are nearly 200 known microbes that can cause food poisoning. While most cases are self-limited and resolve over time without any antibiotics or special treatment, some bacteria (such as Clostridium botulinum, Listeria, certain strains of E. coli, and Salmonella), can actually (although rarely) cause death. While a stool culture and other lab tests can pinpoint exactly what is causing your vomiting or diarrhea, this often isn’t necessary.

Based on a thorough history, focusing on what the patient ate, the time course the symptoms, and what his or her symptoms actually are (vomiting vs. diarrhea, which can be watery, bloody, or inflammatory), it’s possible to predict what the specific pathogen causing your awful symptoms is. For example, vomiting is the common presentation of food poisoning caused by eating Bacillus cereus-infected reheated rice, while while Staph aureus is found in dairy, produce, meats, eggs, and veggies (think potato salad at a family picnic that’s been sitting out too long…yum!).

To prevent food poisoning, anyone handling food should always wash their hands, especially after using the bathroom. Also, the world will severely judge you if you don’t.