A Real Doctor

It's just one day. I remember thinking that on June 30, 2009. The next day I would start as a Med/Peds intern at UT. I would be on the inpatient service at LeBonheur. And I was on call. I didn't sleep much that night. It was just one more day. What significance would just one day make to allow me go from a medical student to having children's lives in my hands? Luckily there were many other experienced people still looking over everything I did that day. I remember rounds and meeting our team. I remember being overwhelmed. I remember a fellow intern crying that night as it all piled on us. I remember making it out the next day. It was another first step of many first steps in this journey.

I think the very first step was probably March 10, 2000. I had never really thought about being a doctor before that day. Not that I thought about it at all that day either that I can remember, but that's still the start. I was diagnosed with testicular cancer that day and formally introduced to the medical field. Somewhere between that day and June 2002 I began to consider it. The thought would creep into my mind from time to time and I would push it back out. Then in June 2002, in Anchorage, Alaska of all places, on top of a beautiful cliff, God finally made it clear about what I was supposed to do with my life. I changed my classes and began the journey into science, physics, anatomy, and biology. All while finishing my accounting degree. I went to the University of Memphis to get the rest of my science classes. Then I had to face it- the MCAT. I think that is why I had pushed the medical field aside so many times. What if I didn't do well on the MCAT? What if I failed? I wouldn't be able to handle it. Luckily I did well. I interviewed at UT and I remember coming home with Katie and my parents to their house the day the acceptance letter was waiting on me.

I don't know that I remember the exact first day of medical school, but I remember all of the early days well. Sitting in a classroom, drinking coffee, taking notes, going to anatomy lab. I would drive home for a couple hours, pack up my books, and head back down to the GEB for a night of studying. I would study in the car. I would study at Tiger football games. Study, study, study. I would do simple word searches at night just to clear my head so I could go to bed. There were good time and there were hard times. Katie was definitely my rock. Then came Drew. Then came Step 1, a good score on Step 1, and then came 3rd year rotations in the clinical setting. It was just another day, but all of the sudden I was seeing and taking care of patients. My 3rd and 4th year rolled along. I remember my pediatrics team well, especially Dr. Chesney. I remember my end of the month evaluation and how they all said I would fit in well withe Pediatrics. For some reason I thought I like medicine as well and set out to do a combined residency in Medicine and Pediatrics, or Med/Peds. Katie and I set out on the interview trail- Greenville, Indianapolis, Cincinnati, Columbus, Little Rock, Lexington, Birmingham, etc. We had the time of our lives on little two and three day trips to places we had never been. I chose to stay right here in Memphis at UT. We had Match Day and party after party around the time of graduation.

And then that day, July 1st, 2009. I started on the Pediatrics side of the whole Med/Peds thing. I soon became miserable. I think it was about my 3rd call when I finally asked my supervisor if it was ever going to get any better. The work just never seemed to stop. I was tired. I felt overwhelmed and drowning. I remember my next month in the NICU at the Med and sitting at that desk out in the middle of all the babies and thinking that I was on call there instead of at a Counting Crows concert at Tunica like I wanted to be. The next month I was in the ED, the month that the swine flu hit and LeBonheur was so busy and overwhelmed that they set up a tent in the parking lot. I remember sitting in a call room before a shift because I had come from a football game and had to work that night. And I sat there and cried because I missed my family and because the ED was busy as hell. We all got sick with the flu that month. That's when I had had enough. Funny thing is that I hadn't even done Medicine at the time yet.

Sometimes it's the decisions we don't make. I talked to a couple of people and got it in my head that I would switch to radiology. Better hours, easier work, better money. To hell with patient contact. Who cares. I could handle it. I started on the Medicine side that October in a Radiology elective that the program director set up for me once I told them I wanted to switch. The next month I did Medicine wards at the VA. I had an interview with the Radiology program at the University of Missouri during the week. I took one day off. Katie picked me up from work the night before, we drove to Columbia, I interviewed that day, and we drove back home so I could work the day after. I took another day off to interview for Radiology at UT. Time passed. I talked with the programs. I finished my Medicine stint in the ED in December. I went back to Peds in January. Wards in January and February. Things began to get better. All of the sudden I fell in love with Pediatrics. I knew what I was doing and I was good at it all of the sudden. The time came to put in my rank list for the Radiology match. The time passed. I never put my list in. I sat on the beach on vacation during Match Day that year, feeling good knowing that I had made the right decision by not putting in a list. I came home and decided I wanted to change to Pediatrics for good.

July 1st, 2010 I started as a second year resident back on the pediatric wards on Dr. Chesney's team once again. I went to St. Jude for two months that year and to the LeBonheur ICU for two months that year. Those were hard but rewarding months. I had never lost as many patients as I did over those 4 months during that year. But I finally knew I was in the right place and fulfilling my calling. It was sometime early in that year that I began to absolutely love my Pediatrics clinic and my patients. I finally knew what I was doing in clinic and I finally had some patients to call my own. I was still considering Oncology, but now General Pediatrics was a strong second. Since I wasn't sure what to do I let my name be put in the running for Chief Resident. Now that I was a straight Pediatrics resident I could be done in 3 years, instead of 4 with Med/Peds. Being named Chief was an honor, but it would mean staying on a 4th year in more of an administrative role. I found out that October that I would be Chief for my class. Sometime in I think May of 2011 I finally made my next big decision. I had some time to kill and I was driving around Memphis. I drove around some rough, run down, poor neighborhoods. I was thinking about growing up in Memphis and about the children of Memphis, specifically the kids I see in clinic and also the kids who go to school at Brinkley Heights Urban Academy, where I serve on their school board. I thought about Oncology. I thought that there will always be people and doctors all over the world who want to support and work at St. Jude. But what about the kids of Memphis? Who will be there for them? And it was then that I realized that would be my calling, to care for the children of Memphis.

I started July 1st, 2011 once again on wards. My third year seemed to fly by. Two of my hardest cases stand out from that year. One patient that I admitted who coded and died later that night. And then one patient who I admitted and only saw a couple times. That patient made an impact in this city like none I've ever known and it was an honor to be able to take care of that patient before their death as well. I still enjoyed my clinic and continued to soak up knowledge and experience. Before I knew it the calendar would turn to 2012 and I would start my year as Chief Resident on May 1st, 2012. We hit the ground running, my co-chief, Stephanie, and I. We made a lot of changes, not all of them our idea and I hope we did a lot of things to improve the program. There was recruitment, scheduling, calendars, manuals, lectures, powerpoints, and on and on. It was a great year to see how things run and to get that experience with people, administration, and everything else that we learned. The last two months we have been covering the inpatient wards as attendings, or "pretendings" as I call since we still have to have a real attending back us up to make sure we aren't doing anything stupid and to bill. It has been a blast. I was afraid I would hate, but I ended up loving it. Don't tell anyone. The teams are great, I've learned a lot, and it's been great seeing patients again. One day this last week I was seeing a little girl and talking to her about the picture she was coloring and I just stopped and though, what a great job I have, I love my job. It's pretty special what we get to do. Luckily all the patients survived, at least that I know of, and so did I. I can't believe it's already over.

So now we're on the cusp of July 1st, 2013. It will be another new beginning. Today marked the end of a long journey and tomorrow marks the beginning of a new career. It's so crazy to think that tomorrow I will just be starting in many ways. It's taken so long to get here. But yet it's really the start. Finally, at 31 and a half years old, after 13 years of post-graduate training, I will be a "real doctor." But it's just another day. And what does a day's difference make in me needing someone to look over my shoulder as compared to me calling the shots. Nothing. It's the years and years of training, hard work, sweat, and tears. It's a start in some ways, but a continuation in many more ways. As a doctor you enter into a lifetime of learning and steps and journeys. I walked out of LeBonheur today for the last time as a resident and I will walk back in tomorrow as an attending. I will be working in the University LeBonheur Pediatric Specialists(ULPS) General Pediatrics clinic in the Outpatient Center right across the street from LeBonheur. I'll be on faculty as an assistant professor at the University of Tennessee Health Science Center. It's been my goal for over 2 years now and I'm so happy that I'll be staying there. UT and LeBonheur have served me well. I look forward to giving back to them, training future doctors, and caring for the children of Memphis.