I am so close to the halfway mark for my hospice and palliative medicine fellowship, and have finally reached the point of breakdown. I've had one about every year of training since the beginning of medical school. For the most part, I've dealt with it on my own. As I think I've blogged about before, one of the biggest hurdles many people in the medical field combat is themselves. Especially in higher training, we all feel like we aren't good enough for what we do. We feel like we've conned our way into the position we are in. Sometimes, that burden if doubt is enough to completely stop us in our tracks. We lost faith in our abilities, and we quit. Sometimes life-changing quits (changing career) and sometimes catastrophic quits (suicide). While, I've never reached serious contemplation of leaving my career or life, I still have self-doubts. Inevitably, there is a point in my training where I feel like I cannot keep up with what I'm supposed to be capable of doing. During geriatric fellowship, the break occurred in September when I lost faith in my ability to be a good clinician due to severe issues with efficiency and timeliness in clinic. I sat in my fellowship director's office and cried. Then she told me that she had been in the same place I was when she started on faculty and wanted to work with me to make sure when I graduated, I would be able to managed my efficiency without issue.
This year, went beyond the typical self-doubt and impostor syndrome. A great part of hospice and palliative medicine is sitting with people who are at the end of their life. They go through the process of determining the impact they had during their lifetime. They try to find meaning in their life and in their death. While yesterday evening's sob fest seemed to come out of nowhere, a clear mind notes that the breakdown was inevitable with the weight of this career choice. I went from thinking I was only a fraud in my career to a full on review of my life. I couldn't understand what I had done to deserve the loving and supportive family that I have or why I was gifted with the care for three cats and a dog. I didn't feel like I was worthy of a man who cares more deeply for me than himself. His care showed yesterday in his sixth sense that there was something more going on than just my usual frustration. He sat silently with me while I folded laundry, knowing that I would eventually breakdown into tears, need him to hold me, and then have him listen as I rambled on about how there was no logical reason for why anyone in my life should care for me. He listened to me cry about how I didn't do anything to deserve the life I have. How I couldn't comprehend why I have what I have. I went through a life review, trying to find meaning to how I'd ended up at this point. I'm about the get married and start my career within three months of each other. Right now, I still feel daunted by the tasks ahead. I'm looking forward to when I can get excited again.
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