Work Text:
I don’t know…maybe I shouldn’t be a doctor…
I can’t seem to do anything right. Carter was annoyed with me for 95% of my last rotation; what am I thinking to go back to this? I still have flashbacks about how bad I blew that one presentation in front of Mark and Romano. Does anyone in this ER even like me? I wonder why they call this place one of the best teaching hospitals in Chicago.
It would be nice to just have one day where I could sleep normally. I’m so tired of staying awake every night thinking about what I have to do after I get home from the hospital when I’m already exhausted. I’m nowhere near as productive as I used to be. Even with the Ritalin, I can’t keep up. Maybe the medication is the problem.
Lucy put a hand to her forehead and tried to take some deep breaths to calm her racing thoughts. She had been diagnosed with generalized anxiety disorder two months earlier, but even after seeing a therapist and taking up yoga, she was still struggling to adjust to her new reality. It felt like everyday brought a new worry, or she’d feel unsafe and afraid for no reason at all. For example, the week prior, she had stayed awake worrying about the student loan repayment that awaited her when she graduated from medical school next year:
I hope I can afford them. All I’ve heard is that residents don’t make a lot of money; the real money comes when you’re an attending. How am I going to survive? I know, make a budget. Live frugally. What if I have to live in one of those dumps with roaches and a shared shower? I’d never survive like that. I should apply for a residency closer to Mom; she did tell me I could come home any time. But do I really want to live with her? It would be so stupid to be a resident, a responsible doctor, and still be living with my mother. What would people think?
No one in the ER, not even Carter, knew of her diagnosis yet. Since it happened over the summer, she didn’t exactly feel the need to go in and announce it to the staff. She had even used the main entrance to the hospital rather than the ambulance bay so she could go to Dr. DeRaad’s office for her initial evaluation. And even then, she wondered the entire time if she was making a stupid mistake by going to County rather than Northwestern or Mercy. But she’d gotten such good marks during her psychiatry rotation that she felt safe in County’s psychiatry department. Fortunately, she hadn’t run into anyone she had worked closely with. Ahead of time, she felt so terrified of running into a coworker that she practiced her cover story over and over: she was doing some research for a journal article about ADHD in adults.
That story worked well enough in the summer, but what would she do on her upcoming elective? If she started spiraling or felt an anxiety attack coming on in a trauma room, how would she explain it then, with all eyes on her? Would it raise doubts from Kerry and Mark, not to mention Carter, that she could handle emergency medicine?
Maybe I shouldn’t be a doctor.
Lucy closed her eyes tight at the sound of the nagging, disapproving voice in her head. She was not going to let it win. Instead, she reached for a notebook and started thinking of all the reasons she could succeed as a doctor. It was a technique her therapist had taught her to help her reframe her mindset when negative thoughts crept in: remind herself of her positive traits that demonstrated why she could overcome her obstacles.
Once she generated a few ideas, she started writing them down in no particular order, titling her list “Why I will be a good doctor.”
I relate well to kids, especially during my psychiatry rotation.
When I’m on my game, I come up with right answers quickly and know how to make a treatment plan.
I have good rapport with my patients and know how to carry a conversation.
She closed her journal and took a deep breath. Maybe it will all work out, she thought.
And with that, she came up with a plan: If she ended up assigned to Carter again, she would tell him right off the bat about her struggles. This year, she was not going to lie about her skills or ask anyone to cover for her. She wanted to advocate for herself and show she was capable, even if it meant proving him wrong.
At the same time, he could be understanding and confident in her when he wanted to be. Maybe it would help them turn over a new leaf in their relationship. But for now, she wanted to enjoy her last two weeks of summer before her next rotation began, and if she didn’t find something else to focus on, her mind would start racing again and she’d be imagining all the negative things Carter would say when he found out. She couldn’t let that happen.
Lucy arrived at County 20 minutes before the first shift of her rotation was set to begin and was happy to see everyone again. Kerry was quick to welcome her back, and she shared some small talk with Carol about how her pregnancy was going. Carol didn’t even bring up the events of last year when Lucy lied about knowing how to start an IV, which is something else she worried about on her commute. What if people haven’t forgotten?
She hadn’t told anyone else she ran into about her anxiety, just sticking to generic answers when they asked how her summer had been. Now, she was debating whether to go track down Carter herself or sit in the lounge for the next 20 minutes and hope he’d come in. She didn’t want to pull him away from a patient, but if she waited too long, she’d likely never do it. Besides, it was just her luck that she was assigned to him again.
Just as she was about to give up and head to the admit desk, he walked in and saw her sitting at the table, organizing some pens to put in her lab coat.
“There you are,” he said. “I figured I’d come meet you this time before you get started. You ready to work?”
“Definitely,” she replied, wanting to sound confident. “You know, I’ve learned a lot after my mistakes from last year, and I’m just kind of eager to put it all behind me. And I hope that we get along better this year too, but I’m sure you’re not exactly thrilled about having to teach me again. I have to admit I was hoping for a different resident.”
You’re not making this any better, she told herself. Stay level-headed.
“Sorry.” Carter shrugged. He seemed to feel the same. “Ever since Doyle quit, we’ve been short residents. And Dr. Finch is on a fellowship, so she doesn’t have time for a student. She’s nice but not really the teaching type anyway. So, hope you had a good summer. Anything else you want to hash out before you pick up a chart?”
OK, he seems like he’s trying. I guess it’s now or never.
“Actually, yeah…” Lucy trailed off and took the cap on and off one of her pens a few times to distract herself. “You’re the first person at the hospital I’m telling this to, besides Dr. DeRaad. Um, over the summer, I actually got diagnosed with GAD. I’m still acclimating and trying to cope with it. It’s been really challenging.”
“Anxiety?” Carter asked. “Sorry…it’s been forever since my psychiatry rotation.”
“It’s OK. And yeah. I’ve basically been in and out of a spiral of negative thoughts and constant worry. DeRaad knows because he evaluated and diagnosed me. I’m not sure if the ER is the best idea for my residency given my condition, but I was already signed up for the rotation and I didn’t want to drop it this late in the game. So, I’m going to power through. And I’ll have to consider what other residencies could be better fits. Surgery is out, too, but then again, I was never in love with the OR. I learned a lot, but it’s not something I want to do.
“But please, all I’m asking is for you to not question me this time or badger me about my medication or anything. I can’t handle it again. Last year was hard enough. I started to wonder if I was having more intense problems after I was worried about how much sleep I’d get when I was a resident. I felt like it was a flag, that the rational side of me would know that residency is grueling and it’s hard to keep your head above water at times.”
“Right. I see what you mean.”
Is he…being nice?
“It’s scary, you know,” she continued. “I don’t sleep well at night, and it seems I’m always panicking about something, whether it’s what residency I should apply to or thinking about everyone’s reactions when they find out about me. They’d speculate like crazy about whether I could handle the ER and they’d be mentioning all the signs that something was wrong with me.”
“Who says anyone has to know?”
Up until that point, Lucy felt like she was just going in circles and dumping her random stream of thoughts on Carter. But when he posed that question, she started to relax.
“You don’t think they need to?” she asked.
“Why would you want to bring that on? This is obviously a challenge for you, and it probably felt like you got thrown for a loop since you already have the ADD. I do know these things can coexist.”
“Actually, while I was scared, it was almost a relief to find out about the GAD. It explained so much about why I felt like I wasn’t finding my place in the ER and was practically sweating when trying to choose an elective rotation. It helped me figure out why I latched onto things about my future career that would be no big deal to anyone else and agonized over them. Sometimes I even go back to my apartment and feel as if I’m drowning again when I’m running low on groceries but don’t want to fight the crowds at the store. Ugh, I’m sorry. I shouldn’t be telling you this.”
“I don’t mind,” he said reassuringly. “If anything…I don’t know. Maybe it’ll help us work better together this year. It’s certainly progress from last year when you lied to me about the skills you had. Now you’re communicating your limitations and your struggles so I can give you a little more leeway. And look, I was wrong too when I was an ass about your Ritalin.”
“We already talked about that,” she remembered, thinking about how he apologized when they ran into each other at Doc Magoo’s. “I think we were both pretty eager to make it water under the bridge.
“You really will be easier on me?”
“To the extent that I can on an ER rotation. Unfortunately, I can’t shield you from traumas, but I can let you sneak away for some extra break time when things are slow if you want to catch your breath. Or if I notice you’re getting overwhelmed in a trauma, I can see if we need any supplies and tell you to grab them, or let you do the procedures you’re best at. These are just some ideas right now, but we’ll figure out a plan.”
“Thanks for understanding. This made me feel a lot better. I’ve only been able to talk to my mom and Dr. DeRaad about this for the most part, although I told a few professors too to see if they could give me any ideas for how I could ask for accommodations. But I don’t know if I want to use accommodations in the long run. I’ll think about it.” She didn’t want Carter to question her abilities again, after all, if she asked for extra time to prepare for presentations for rounds.
“Carter, Lucy, where have you been?” Kerry asked, looking annoyed as she barged into the lounge. “Lucy, I know this is your first shift back, but I was hoping you would have already been out here working on patients. Carter, we have an MVA coming in and I’m going to need you.”
“Need me too?” Lucy asked.
“Not right now. Only two majors. Pick up the first chart you see and get moving, and run it by Carter after the trauma. Let’s go.”
When Kerry left, Lucy and Carter looked at each other and sighed.
“She didn’t change.” Lucy observed.
“Not a chance. Hey, you didn’t hear this from me, but take a couple more breaths before you get out there, OK? I think you’re going to need them.”
After Carter headed out, Lucy pulled out her compact mirror. She quickly brushed her hand through her hair, and while she was starting to get nervous to see a patient and be more independent than she was in her third year, she tried to smile, hoping to get a head start on combating any negativity sneaking up on her.
Even though it didn’t always feel like it when she was trying to fall asleep or crying and trying to breathe during times when she was catastrophizing, she figured that eventually, things would all work out and her second rotation would go much better than the first.