Signout is hospital slang for the transfer of information between patient care teams. It is also the name of this blog, which represents one of the less dysfunctional ways in which Dr. Signout copes with her participation in a U.S. medical residency program.
I was in the olive department at the local market a few weeks ago, when I heard a voice from in front of the Cerignolas. "Dr. Signout? Is that you?"
At one look, I knew who it was--the father of a girl whose forehead I'd sewn up months ago, near the middle of my intern year. I smiled, made chat, inquired after the girl, and cooed appropriately about her impending entry into kindergarten. All the while, I fought the overwhelming urge to bolt, because moments prior--seeing only the rear view of the father and son--I had cursed them under my breath as I'd impatiently maneuvered my shopping cart around their slow-moving bulk near a baguette display.
It was the first in an improbable string of patient sightings around town. I dread patient sightings. See, what with my repression of all normal human responses to frustration during professional interactions, my growing well of molten anger occasionally overflows in public. Patient sightings suggest that I'm going to have an increasing number of professional interactions in public. If the public becomes a professional stage, I'll have to repress my normal human responses to frustration there, too.
Which begs the question, where does the anger go? I have no spouse to pick on and no puppy to kick, and I can't get all of it out while driving.
I don't know if the anger I feel is normal, and I don't completely understand it. It's much more than I had during my intern year; perhaps that's because I was expecting my intern year to be a living hell.
I acknowledge that my second year of residency has not been all I thought it would be. I feel a loss of control over my own life that began with the match and has since built into a rhythm that incessantly thrums "beholden! beholden!" I am tired of being the property of my home institution. I am tired of having to lower reasonable expectations just to function within the health care machine. And I am just tired.
The anger is a normal human response, and I am only human. But do my patients really need to know that?
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Comments
You could always channel it to sex.
Posted by: Jeb, FCD | August 15, 2007 9:31 AM
This is a disagreement I have with my wife quite often. She blows up on occasion, and doesn't really seem to understand how much it affects me. When I suggest to her that she needs to find a way to let go of her anger, she argues that it has to go somewhere. She has to do something with it.
I wish I had the right answer for you, but just letting it go seems to work much better for some of us than for others. :(
Posted by: Dennis | August 15, 2007 9:52 AM
You might want to consider martial arts, or some other very strenuous physical exercise. They can help a lot - though I would warn against sparring while very pissed. It's considered impolite to break your toys^H^H^H^H sparring partners.
Posted by: Martial_Artist | August 15, 2007 10:01 AM
I thought that was what blogging was for.
Posted by: isles | August 15, 2007 11:17 AM
Sing, or do some other music. Trust me, it helps.
Posted by: nosugrefneb | August 15, 2007 11:29 AM
When I was working in a small town, I had kids that I worked with (or their families) that I saw constantly. Mostly, the kids didn't want to let folks know they saw "the psychologist" and would smile but not speak to me. The parents always came to talk. Moving out of the small town to a big town (or living in small near-by town) solved this problem.
Also, after 7 years of grad school/ internship/ residency I felt a little crazed by the constant "guidance" that comes from advice and supervision as a trainee. Now, I am in a position where I supervise others, and my frustration and powerlessness seems to have disappeared. Just give it time, and a lot of the things that bring about these feelings will get better.
Posted by: K2 | August 15, 2007 11:42 AM
You could use a hug...some meat loaf...some red wine...something that makes you forget...just as long as I get some of all of the above. You can't quit though...you're too good and that's my schtick.
Posted by: slander | August 16, 2007 1:57 AM
Living in a big city is good advice...this is exactly what I was talking about a year or so ago with you about how the medical profession needs something like Clinical Pastoral Education (CPE) has for hospital chaplains. It seems like you need some sort place to process all of it. Those of us in caregiving roles are human and we need a safe, human outlet away from our patients/parishioners, etc.
LF
Posted by: Anonymous | August 16, 2007 3:27 PM
Ach - if you had any predictable time, I'd suggest bread making for the opportunity to pummel the dough and generally slap it around.
Posted by: Shinga | August 17, 2007 1:50 PM
Intersting ideas. Bread making and music - intersting beginning.
Posted by: A.L | August 19, 2007 9:12 AM
Have you considered cage fighting on the weekends. This seems to be making a big splash in my locale. Of course, you will inevitably end up stitching up a few of the participants/opponents and then you've come full circle again. Better find a spouse to pick on.
Posted by: misha | August 20, 2007 1:55 PM
Martial arts? Not coordinated enough.
Big-city living? Not mobile enough.
Meatloaf and red wine? Too hot.
Bread making? Too many carbs.
Musicianship? Bad for everyone involved.
Sex? Yyyyyeah.
Cage fighting?
Sold!
Posted by: Signout | August 28, 2007 11:56 PM
Meditation. I know you hated the "Mindfulness" lecture, but it is the best way to deal. See
http://docwhisperer.wordpress.com/2007/02/01/meditation-and-health/
Posted by: docwhisperer | September 6, 2007 1:51 PM