When did you really feel like a doctor?

Oct 21 2010 Published by under Medical Musings, Medicine

The Doctor, Samuel Luke Fildes (1843-1927)

Yesterday on Twitter, my friend and colleague Dr. Isis noted that she still gets a sense of surprise when she sees "Dr" next to her name in an email.  She, Alex Wild, and I wondered what are the experiences that really make you feel like a doctor (in this case, PhD or medical doctor).  So I started wondering: what are the experiences that made me really feel like a doctor? Was it the white coat ceremony?  Dissecting a cadaver? Wearing scrubs and a stethoscope around my neck?  All of those are important steps, and important memories for me.  But as I thought about it, I was taken back to a particular night in a particular place.

My residency program had a night float rotation.  Three senior residents would be in the hospital from 11pm until 7am (more or less), each covering a different set of patients.  We would run cardiac arrests, admit new patients, and put out various (metaphorical) fires.  And we would pronounce patients dead.  Each of us shared the duty, on a nightly rotation, of covering the inpatient hospice service.  On one of my first night float calls, my pager went off, directing me to call the hospice unit.  They asked me to come down and pronounce someone dead.  I walked down the hall (no hurry, right?), got on an elevator, walked down another hall and into the calm, well-appointed unit, with its gentle lighting, living room couches, aquarium (at least, I think there was an aquarium).  The nurses directed me to a corner room.  The lights were low when I walked in, and a man was laying in the bed.   His color was---wrong.  Everything was wrong.  I walked over and tried to wake him up, shaking him and calling his name.  I took out a penlight and lifted open an eyelid, my fingers resting on his cold, sweaty brow.  His pupils didn't react.  I placed my stethoscope on his chest and watched and listened for a long time.  There were no breath sounds, no heart tones.  He was most certainly dead.  I called the attending physician and the family, waking them both, and sat down to do my part of the "death kit", which included the death certificate.  After a few jests with the nurses, I walked back out into the harsher light of the living.

I'd never felt more like a doctor than I did that night.

6 responses so far

  • St Thomas says:

    My moment came working as a General Practitioner, about six months after finishing my trainee year. I was working freelance, and I had an engagement covering a GP cooperative association, in the East of Scotland; a midnight to eight shift. I was on call directly to 70,000 patients covering any and all medical problems (except trauma). I knew that I had reached the point in training and experience, where I was confident of handling anything that came my way, and I felt quite calm about doing the shift, for the first time since I graduated.

  • DrV says:

    Really interesting post. I have ideas on my own but too long for here. I'll post here in the next day or two. Thanks for the trigger.

    The length of this post is perfect, BTW.

  • anatman says:

    interesting story. the stethoscope thing seems to be quite a psychological rite passage. i am not a doctor, but i used to be an ambulance attendant (before there were emts in detroit). i had lost patients before, but the first time i arrived on scene and the patient was already clearly gone was a real mental watershed for me. i placed the stethoscope on the poor woman's chest and all i heard was people playing poker in the basement. it brought home to me that as a responder, you have to care because there may be no one else that does.

    off topic, are you aware of the new michigan skeptics drunken skeptics podcast? they start off with a bang with an antivaxxer. they interview the antivaxxer and intercut the interview with discussions and debunking among themselves.


  • Alex Wild says:

    Even 5 years after receiving my doctorate I'm still surprised when I hear "Dr. Wild". The singular anti-climactic event of receiving the degree didn't correlate with much anything. I had started to receive respect for my particular area of expertise well prior to finishing graduate school in terms of conference invites, job interviews, and papers to review.

    But I graduated into the postdoctoral ether, where I still linger largely by choice (tenure-track is not so compatible with a nature photography business), and soft money positions aren't accorded the status that one associates with "doctor". Perhaps at some point I'll start to feel doctorly, but I do hope that in my case it doesn't involve anyone's death.

    Thanks for the link love.

  • tideliar says:

    For me it was being at a conference and holding my own against a very inquisitorial crowd of profs, postdocs and grad students. I realised I *was* a scientist at that moment - walking the walk and talking the talk.

  • (not yet) dr. Raul says:

    I'm still only a student, and sometimes I wonder... how is it going to be... being a doctor I mean.
    wonderful post, greetings from Mexico.