the emotional roller coaster that is residency

Being here can be incredibly stressful- physically, emotionally, intellectually. I do not have any strategies for dealing with all the problems I am constantly being bombarded with. Some days the nursing and ancillary staff are so hostile that I want to cry. Literally, I want to sit on the floor and bawl my eyes out. I feel so bullied most of the time. And the worst part is that I dont have it in me to yell back, even though I know that I am in the right.

The intensity of my emotions has really been a big surprise to me. I am normally so mellow (at least I think so). Lately, I have been feeling like a monster. I dont like myself. I dont like my moods, my anger. I called my boyfriend a 'dumbass' the other day- not directly. I never have a bad thought about him, it's my language that is out of control. My anger has turned into Tourrette's . I curse so much more than I used to. It has been the only way for me to express myself. It happens when I am talking to people I know on a more casual level. But I dont feel good about it. Saying, "Gosh, Im so steamed about this!" doesnt really relieve the fury.

On reflection of this past week, I find myself feeling more avoidant. I am developing this emotional detachment. I dont know if this is a good thing. Maybe the next step is letting little things go if I can get away with it- not because it is not important or the right thing to do. I dont want to be 'that person' but I am tired and emotionally overwrought. When some nurse or whoever gets in your face and starts bitching, I feel myself shrinking. The person that I am (that I think myself to be) is fading. My dearest twice told me that I am the gentlest, most elegant person he knows. I cry when I think of those words, because that person is being killed little by little. I dont want to carry myself in a way that I deem to be less than ideal, but I can barely hold my head up some days. I have to remind myself to not look at the floor. People criticize the cold and detached nature of physicians- how can I do my job with any humanity when I can hardly breathe?

I had a patient with a chest tube and collapsed lung who suddenly complained of chest pain. I asked the nurse to check his O2 saturation and she told me she just came in and was too busy. I went looking for the Pulse ox machine and a tech to help me and he gave me the same, "I've got other things to do and if you think its so important go do it yourself." It was a big deal to check the oxygen level on a patient who everyone know should be checked regularly. When I discussed this situation with a senior resident, he said to me, "You're just buying your time here for one year. Just do it and get out. Havent you realized yet that patient care is not the most important thing here?" My lesson for that day. Oh, and yeah, when I finally got a chest xray for my patient, his pneumothorax had expanded. Lucky for him he has another good lung to compensate.