I'm only four months into my third year clerkships and though my understanding of this subject will continue to evolve, I would be lying if I said I hadn't caught glimpses into the abyss of what it could mean to become jaded. This is meant to be a positive post, but I'll try to shed some light on some experiences I've already encountered that may contribute to the issue.

Coming from first and second year "patient instructor" encounters where the history portion of the H&P is carefully planned and the answers are consistent, transitioning to interviews on clerkships presented new challenges. Among these are patient forgetfulness and omission of pertinent information, or simply not asking the right question at the right time. Missed information can be very stressful, and even embarrassing, when you're confronted about it on rounds. This is something that happens to all of us, we're learning how to be doctors after all and mastery takes time! I think the only way to feel confident even if you do forget to ask something, or if you've gotten different information than your attending or resident is to try your best. There's no shame in that. Nevertheless it can be easy to be discouraged, and even place resentment on patients or your superiors.

Another big example that has been on my mind a lot lately is that of being too "naive." This is something I've been told (and heard my fellow med students get told) over and over. I think that as freshly minted third years we are simply excited to be working and learning actual medical management in real-time and that this excitement comes with a willingness to learn, to be inquisitive, and to be positive. It's an unfortunate reality in medicine that our patient's often come with a litany of social issues that can affect their health and must be addressed. Although varied, this includes things like poverty, homelessness, lack of access to food, and abuse. Nowhere is the issue of being too naive more obvious than in pediatrics, however. Child abuse and neglect is a horrible, and very real problem. In order to protect our patients we must question everything, from the validity of their lab results to the honesty of their caregivers. Children are an extremely vulnerable population and generally cannot advocate for themselves. As medical students we like to give everyone the benefit of the doubt. We like to envision our adorable pediatric patients as loved, cared for, happy. But that's not always the case, and I think it's these cases that make it hard for medical professionals to remain trusting. The most intense stories I've heard have actually come from the nurses I've worked with and how it changed their views of patient care for better or worse. I appreciate their candor in retelling these stories so that I may learn what to look out for and help me realize that caring for patients can often be extremely emotionally challenging.

I might be a naive medical student, but as of right now I refuse to become "jaded." I hope that the experiences I come across these last couple of years of med school, residency, fellowship and beyond will help me become a better person for the benefit of my patients & their problems, not in spite of them. I hope that the lessons I learn along the way help me develop a healthy sense skepticism that does not compromise the care of my patients. Some of my goals as I venture forward are to stay positive, compassionate, committed to service, empathic, but realistic. To that end, I'd like to share one of my favorite quotes from none other than Khalil Gibran: