No second chances

So I definitely had another revelation today.  It's been shown that medical students are the most cynical and least altruistic during their third year.  Having spent a lot of time in the field, I definitely had my period of complete bitterness and misanthropy as a paramedic, but now that I've already hit that period I thought I wouldn't go through it again.  I think that everyone in the medical field, at some point early in his or her career, experiences this common feeling of frustration: the system is messed up, and it needs to be fixed.  And everyone is right, except that really, it can't be fixed.

So again, I thought I was done with that.  I'd moved on, accepted the fact that I can't really change the big picture, that I need to just focus on my own patients.  Most importantly, I have to accept what they tell me- regardless of my feelings or opinions- except in absolutely definitive and obvious cases.  And it took several years and thousands of patients to get to that point.

Anyway, this evening I realized that I'm just as cynical as I was at my lowest point and I couldn't figure out why. Walking around with Bandaid, while trying to keep him from bolting at the several groups of people he was madly barking at, I figured it out.

Really it started with me trying to figure out why people keep walking toward me and Bandaid when he is growling and barking and acting vicious, obviously making it extremely difficult for me and putting them at risk for a nasty bite (which they may or may not deserve).  Or why someone gets startled when he barks, even though he or she knows a dog is right there.  Why are these actions repeated over and over again, when they know what the potential consequences are??

It suddenly struck me.

"The definition of insanity is doing the same thing over and over and expecting different results."

I freaking get it.  My cynicism has NOTHING to do with medicine, it's with people in general.  When people are hurt or sick, they come to the hospital.  It may just be a cold, but they haven't studied medicine intensively like I have.  I can't justify getting frustrated with someone who doesn't know that it's just a cold and that antibiotics won't help at all.  You can't fault the child who reaches up to the boiling pot of water and burns his hand the first time- because usually it's his last.

But when someone does something absolutely stupid, knowing that it will lead to something else that is stupid, I get frustrated.  If you don't do your homework, don't be surprised when you fail the class.  If you walk into traffic, don't be surprised when you get hit by a car.  If you bungee jump off of a bridge, you can't really be surprised if the cord breaks.  If you snort cocaine, you're probably going to overdose or die of a heart attack.  People are conditioned to NOT do stupid things from the day they are born, yet they continue to do it.

But as a medical student, I'm expected to get everything right the FIRST time.  Even if I haven't seen it before.  Imagine a doctor who sends a patient home with a heart attack.  And then does it again.  And again.  This would absolutely never happen.  An attending can justifiably yell at a student or intern for doing something incorrectly even if it's the first time he or she has seen it or done it.

Guess that's why perfectionists go into professions where you don't get second chances.