One year ago... one year from now...

My nephew turned one year old today.  It got me thinking about my life one year ago...

When he was born, I was taking my Step 1 USMLE boards (translation: 8 hour national test at the end of 2nd year)- running out to check my cell phone during my breaks so that I could know how the labor was going.  I even had the administrative-assistant-lady on my side- she would let me know if my cell phone had rang or not when I came out for a break. I thought I knew everything there was to know at the end of that test.  I'd been studying for 4 weeks, and everything in medicine seemed to fit together in a neat, tidy package.  But I was terrified of doing a pelvic exam, or telling a patient about a cancer diagnosis.

But then I started third year- and I saw patients die who should've lived; and live who should've died. Medicine got very complicated.  It became more and more about luck than facts.  Whereas medicine had seemed very much like a science to me one year ago; I now know  much more about the art of medicine.  Just today, I was seeing a ovarian cancer patient and told her about her diagnosis for the first time.  The right words, surpisingly, came naturally to me.  You would have to ask her- but I think I did an awesome job.  That situation would've made me pee my pants a year ago.  The facts meant much less to her than the open discussion and emotional support.

But don't ask me how an antibiotic works.  One year ago, I could've explained the mechanism of every single one- now I'm just happy if I remember that it's antibiotic. But I can tell you everything you'd ever want to know about the patient who I saw who had a bad reaction to it. 

And one year from now?  I'll have a two year old nephew, I'll know where I'm heading for residency, and I'll probably be getting ready to move to a new city, and I'll be within a month of having an MD behind my name.  I'll probably feel just as incompetent and unprepared to be fully responsible for patients as I do know- but at least I'll have an extra year of experiences under my belt.