Beyond Studying

During my OB-GYN rotation early in my third year, I had just spent the entire night running around the hospital with the night float, evaluating patients, observing emergency C-sections, and assisting in deliveries on the labor and delivery ward. Medical students were allowed to call it a day by 7:00 a.m., if they had been in the hospital the night before. Needless to say, as morning came, I was looking forward to heading home and getting a good dose of sleep. As I looked at my watch, I realized that it was about twenty minutes before seven, and the night float was finishing up with his duties. This hour also marked the time when the incoming medical students were required to show up for morning report, held by the residents and attending in the hospital cafeteria.

By this time, I was staying awake by sheer willpower. I was running on fumes, but a crazy thought (probably due to the lack of sleep) ran through my head. Why not stay for morning report? My heart swelled as I thought of the sacrifice of sleep I was making in order to advance my knowledge of obstetrics. After all, it wouldn’t be too demanding. I would just sit in, contribute what I knew to the group, and leave inspired. Instead of saying good-bye to the night float, I lingered around. Less than five minutes later, another resident who had just arrived came tearing around the nurse’s desk and pointed at me: “You’re a medical student, right?” I nodded. “Good, you’ll be giving morning report today. Let me find you a patient …” She ruffled through some papers, and with about fifteen minutes to go, I was frantically taking notes from the patient’s folder, as I mentally rehearsed how I would present the case. I quickly wrote down all the labs and looked up on the computer all the dictated reports I could. As I wrote, I felt all my remaining energy drain slowly away.

At 7:00 a.m., we were in the hospital cafeteria, and I was discussing the patient. The attending peppered me with questions, which I thought I answered well. Of course, I was somewhat delirious after having been up most of twenty-four hours. As everyone was leaving after the report, the attending pulled me aside along with the resident and took me by surprise by saying, “That was the most unprepared morning report I’ve heard! You had all night to get ready for this. Next time, get your information and your act together.” In my shock and fatigue, I couldn’t argue—I really wasn’t prepared—but inside I was seething. “When you get a patient,” the attending continued, “you should have followed her throughout the day and studied up the night before about this particular presentationwhich you obviously didn’t do. I really didn’t like this talk, so you should do another one. But make sure next time you go over it with me first before you present it.”

I bit my lip as a part of me within screamed, “I don’t even have to be here! I came out of my own goodwill. A resident accosted me to give this morning report! It’s not my fault!” Here I was, being berated by an attending, when I could have been getting much-needed rest in the deep comfort of my blankets. But in the midst of waves of raw emotion, I kept my mouth shut and tried to swallow the positive aspects of his criticism, which felt like chugging a two-liter bottle of contrast. In front of my peers and several residents, I felt as if I were the one getting a pap smear!

One of the residents eventually stepped in and spoke up for me, but for me the damage was done. I trudged home, angry and exhausted. You can imagine the frustration and bitterness I felt, not just because I felt wrongly accused, but because my “image” was now tarnished, and a bad evaluation was pending! My cynicism grew. No good deed goes unpunished, I thought. Here I was, voluntarily staying after a tiring call in order to expand my knowledge base, only to be slammed with accusations of lack of knowledge and preparation, along with getting a potentially negative evaluation. How would you respond in such a situation? Better yet, how should you respond?