Wisdom in a Time of Change

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It’s hard to believe another academic year is coming to an end. Another crop of medical students who have struggled through the long Match process will finally start out as interns. Junior residents who have become more fluid with procedural and clinical competencies will assume new roles as senior residents, leading and teaching in the ED. And for all of us graduating residents, these next few weeks hold our last moments of residency, which for many of us means saying some bittersweet goodbyes.

While change brings the excitement of starting anew, it also carries the memory of where we’ve been and those people and experiences that made us who we are. As I get ready to leave Fresno behind, I can’t help but remember some things I’ve been told over the years that come back to me in moments of transition.

“It’s easy to be the star. But it’s who you are in the darkness, behind the curtain when no one is watching that shows who you really are. Be sure that person is the one who makes you most proud.” Sister Dolores, my high school principal, was a woman of few words, but the ones she did say were very intentional. She shared this with me my senior year, and while we were talking at the time about some high school musical drama, the message was clear and remains pertinent as we take on new challenges. It’s easy to be an amazing provider to those we readily feel compassion for or the patients who make us feel appreciated. But it’s how we treat those who test our patience, irritate us, or push us to our limits that matters most. It’s how we talk about our colleagues and support staff behind closed doors. It’s staying late to advocate for a patient or help a teammate when it’s the right thing to do. It’s being the best you all the time, not only when you know people are watching.

“You never know where the road will go. My advice? Take the road.” Dr. Julio Veinbergs, the OB/GYN who delivered me, remains a close friend of my family and is full of sage advice. He shared this with me when I was deciding whether to go back to school to complete a post-bacc and pursue a career in medicine. To accomplish our dreams in life, we often have to give up what is comfortable — move away from our friends and family, leave the neighborhoods we know by heart, and start over in the process of gaining “street cred” and a reputation in our workplace. This process is fraught with uncertainty, which is nobody’s favorite feeling, but we have to take the road to discover what life holds in store for us — what amazing people, places, and experiences are waiting just around the corner and often change our lives in ways we could never imagine.

“Fail, my friends! It is only in failure that you grow, and only those who grow will find success.” Dr. Fred Kiesner, one of my undergrad professors, was a huge proponent of celebrating your failures. Nobody is perfect, no matter how hard we try. As doctors, we are bound to make mistakes. We will miss diagnoses, order the wrong medications, say the wrong thing at the wrong time, not know the right answer… This is inevitable. But if we let ourselves learn from each mistake, if we rise every time we fall, then every shift we will be smarter and better than we were before until we’re truly the experienced and excellent clinicians we set out to be.

“When all eyes are on you… wink.” OK, this one was actually on the bottom of a Mike’s Hard Lime cap, but I love it and feel like it definitely applies in those moments when you have to be “on” and don’t feel 100% confident. As a new intern or senior resident or new attending, we all will have moments when we internally panic but need to be cool and collected on the outside to help everyone else in the room stay calm too. Just remember, EM is a team sport. You’re never alone and we’re all in this together. No matter where you are, your EM faculty are there in the ED where you trained 24/7/365 — and that’s only a phone call away.

Whatever transition you’re making this year, here’s to it being a smooth one! And on a personal note, a huge thank you to all those who helped shape me into the doctor I am today, and to those who will continue to push me to be a star even in the dark — with every person, every time.

Keep on keepin’ on!

Alicia Kurtz, MD

Alicia Kurtz, MD

EMRA President, Chief Resident, UCSF Fresno, Fresno, CA, @aliciakurtz_md
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