The Confidence to Drive on the Other Side of the Road

28 05 2013

Time has flown by, and I am now at the end of my third year of medicine.  I am currently doing my rural family medicine rotation in a small town in Australia, and I have been loving my time here.

Because it is a small town, the only way to get around is to drive, and, of course, in Australia, they drive on the left side of the road, which is the opposite of what it is like in Canada.

Now if you had asked me whether I could drive on the other side of the road a year ago, I would have told you NO WAY, especially not in a big, crazy busy city like Sydney (which I did just last weekend), because I hadn’t driven at all for three years, much less on the other side of the road.

Now I’m sure there are readers who will be thinking that I am silly for thinking that driving on the other side of the road is a big deal, but you should know that I am so anxious and hesitant, getting myself so lost in the potential consequences of my actions that I can too often become paralyzed and fail to end up taking a step at all.

So then how was I able to be bold and brave (as a couple of my colleagues put it) and drive on the other side of the road in a new country in a busy, chaotic city with massive traffic and poorly designed roads (Sydney) when I haven’t driven in three years?

Well, it’s all thanks to trauma surgery.

The short answer is that when you learn how to deal with patients coming in with gunshot wounds, stabbings, massively broken bones, and injuries from being hit as a pedestrian by a car; you become less stressed about the littler things.

The long answer is that I absolutely loved my trauma surgery rotation, and found it an incredible privilege to be there.

Watching the surgery residents deal with incoming trauma, I noticed how calm they were.  The patient could be unconscious with massive wounds and completely fractured bones, but it was as if the more serious the situation, the calmer the residents were.  Patients would sometimes have massive hemorrhages, be deteriorating quickly, and require immediate intubation/chest tubes/etc; but unless you were experienced, you wouldn’t be able to tell how serious the situation is from watching the staff calmly at work.

Wanting to be effective, efficient, and optimally care for my patients; there were a couple of times when my voice started speeding up and increasing in pitch, my walking pace became more rapid, and my shoulders tensed themselves up reaching towards my ears.  I felt like I needed to quicken my pace to take care of the patient this second, but twice I remember two different residents telling me to chill out.  I remember then recognizing how stressed/anxious/frustrated/impatient I was at the time, and I deliberately took deeper breathes, relaxed my shoulders, and smiled gently.  It was as if I was doing a heavily simplified form of mindfulness therapy on myself.

But hey, it worked.

The biggest lesson I took away from trauma surgery was why I needed to be calm.  I will be always grateful to the residents who made me realize that when my shoulders tensed up, my brain also tensed up.  I would lose my ability to think coherently, I would become extremely absentminded, and I would lose (most importantly) my sense of humour.  Essentially, in times of stress I lose who I am, and that, beyond turning me into a mindless automaton, has the side effect of rendering me useless as a clinician, to the detriment of my patients.

Sometimes it feels like if I am too relaxed at work, I am not doing my job right.  I worry that if I am too calm, I am forgetting something important.  But actually the opposite is true.

I worry that making jokes and allowing too much of your personality to show through is arrogant or unprofessional or a hindrance to my performance as a future doctor.

Well, now, I think that it still is a very delicate line, but I know now that if I become so stressed that I lose my sense of humor or I worry so much about doing the right thing perfectly that I become paralyzed, not only do my patients suffer, but it is not sustainable for my career.  If I lose my ability to enjoy the work that I do, why am I going into work at all?

So thanks to the month with my incredible trauma surgery team, I learned how to be calm in the craziest of situations.  I try to remember that joking and laughing at the right moments is not unprofessional or arrogant, but necessary and important for patient care.  Whenever I feel my shoulders tense up and my voice quicken, I take a deep breath and I remind myself that if I can handle patients with gunshot wounds, perforated appendices, and ischemic bowel in a calm, logical manner; what’s a little bit of driving on the other side of the road on the other side of the world?

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