Get Comfortable with Being Uncomfortable

This idea of feeling or becoming comfortable with certain clinical situations has been on my mind lately. You see, I am a doctor that practices old-school, full scope medicine. There aren't many of us out there anymore -- we are sequestered in remote locales and wild hinterlands of the Canadian North. We are an eccentric and diverse group. We have many varied attributes, and we all have fascinating tales of triumph and woe.

 

What do we do? Well, basically, we do everything and anything that we need to do. We don't have the luxury to defer or refer urgent and emergent cases to someone else with "more knowledge and skills." Nope. Sometimes we are the only physician there. So, how do we do this? How can we be so omnipotent in our vast knowledge and skills so as to allow us to be comfortable handling any possible emergency imaginable? AHA! There's that word -- "comfortable." Well, frankly, comfort is another luxury we can't have -- because how does a physician gain comfort with anything? Through repetition with numerous similar cases. Nope -- not going to happen. Those terror-inducing, knee shaking emergency situations don't happen everyday for us -- they don't happen every week, or every month, or even every year. AND, similar cases don't keep happening to the same physician. So, scratch "comfortable" off your list of things you think you need to attain before you become a rural doctor. If you choose to run around getting as much extra training as possible prior to "going north" so that you can feel "comfortable" with those emergency situations -- that's fine, but you should know that it won't last. You can only maintain that feeling of comfort with continued, regular exposure to similar situations. Not going to get that.

 

So, what is the secret of the eccentric, rural, northern doc who is long in the tooth? Come, sonny, and sit on my knee. I'll whisper it into yer ear, "We have courage."

 

We have the courage to be uncomfortable. We are resilient, resourceful, and humble. We are brave enough to do what we are afraid to do, because we know we have to. We have to try. We have to do our best for the sake of the patient, and for the sake of our own integrity as doctors. And, yes, we are humble -- we know our limits and our weaknesses, and we do everything we can to accommodate them: we phone the distant "experts" for advice, we call our local colleagues (who will come running if they can), we pull our books, we poll the nurses and anyone else for input. But, in the end, we have to be able to make the judgement calls and take action. Sometimes we are heroes, and sometimes we are defeated.

 

The specific clinical skills and knowledge that I gain from each of these sort of encounters may or may not serve me again in the future, for, after all, when will I see another similar case in which to apply them? BUT, I am changed. My character is strengthened. My courage has been tested. I made mistakes -- I can own them and reflect on them in a healthy, constructive way, OR I can hide them in shame and they will haunt me for the rest of my life. I have done both. I have also done some amazing things that I did not know I could do.

 

So, my advice to the "newbies" who are venturing into this realm -- don't confuse "comfort" with "competent". Don't wait until you feel comfortable. Don't hide yourself in years of extra training. Get comfortable with being uncomfortable.