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Aequanimitas - David Pearse’s Biennial Musings
Aequanimitas Spring 2015
David Pearse’s Biennial Musings
Date: March 30, 2015
In 2013—30 years after completing my training—I attended our Johns Hopkins Medicine Osler housestaff reunion. Though I didn’t expect to run into anyone I knew from the early years, I heard someone call my name and turned to find three of the Barker residents responsible for shepherding me through the internship year.
My initial reaction was similar to that of someone who runs into the firemen who had pulled them from a burning building. Of course, they didn’t pull me from the burning building, because they were stuck inside too. Rather, they showed me how to survive in that building for long stretches of time without getting burned.
This is not about how things were so much more difficult back then compared with now. Medical housestaff training has evolved—mostly for the better. What hasn’t changed is being faced with an impossible amount of information and experience that must be mastered in 12 months.
My biggest struggle came after my first few days with my medical residents. Somehow, the single year that separated us in age and education had transformed them into clinical wizards who seemed to always know exactly what do to and were never flustered in the most chaotic situations. I should have taken comfort that all of the junior residents had made this transition and therefore so would I. But my reaction was the opposite.
My vulnerability in this regard was fueled by my experience on July 2, after my first on-call night on Halsted 5. I had stayed up all night working up four new patients, but by 8:30 a.m. work rounds, only two of the write-ups were completed and clipped to the chart.
After perusing the charts before rounds, one of the two junior residents on that service informed me that at Johns Hopkins, all the patient write-ups are in the chart for rounds, and that if I didn’t think I could do that, perhaps I should consider returning to my place of origin. This encouraging piece of advice came from someone who just two days before was also an intern. Fortunately, his educational style was unique among the residents, and one of the many improvements in our housestaff training program has been the nurturing tone toward our junior trainees.
I encountered this resident 20 years later at a research meeting and was pleased to note that he had gained 30 pounds and lost most of his hair; but I digress. Sitting now at the reunion table with my residents 30 years later, I was the intern again. But all I could feel was a sense of profound gratitude and relief that this time, my internship would end after dessert.
David Pearse is medical director of Johns Hopkins Bayview Medical Center’s medical intensive care unit.