Mark Lewis: It’s been Exactly 20 Years Since My First Day of Internship
Mark Lewis, Director of Gastrointestinal Oncology at Intermountain Healthcare in Utah, posted on X:
“It’s been exactly 20 years since my first day of internship.
As I reflect on my disproportionate aging since then (gray hairs >>> wisdom), here are my 10 unsolicited recommendations for any colleague embarking on residency.
ADMIT WHAT YOU DON’T KNOW
You’ve never had more info at your fingertips (whereas I showed up day 1 with so many reference books stuffed into my white coat pockets that the seams split) but specifically NEVER fabricate patient data! Rather: “I’ll look it up and get back to you”
ASK FOR HELP
My 1st overnight call, I was so proud of myself for reversing a prolonged PTT with protamine when I could have just held the heparin drip. When I told my upper level in the morning he was half-bemused, half-furious that I didn’t seek oversight. You are NOT alone.
SELF-CARE ISN’T SELFISH
I know it’s a cliche but sleep when you can. There’s little valor (and even less educational value) in pushing your brain & body into a state of sustained insomnia.
TREAT EVERYONE WITH GRACE (INCLUDING YOURSELF)
We all make mistakes, especially under pressure. As in 1) above, admit your errors as quickly as possible, and also “show your work” in your documentation (copying and pasting others’ H&Ps is like having ChatGPT write your essays).
IF NURSES ASK YOU TO SEE A PATIENT, DO SO
Their (highly proximate!) clinical judgment matters too. Best-case scenario? You can intervene meaningfully in the care of a patient in extremis. “Worst”-case? You can reassure everyone (yourself included) & rest easier afterwards.
IT’S CALLED BEDSIDE MANNER FOR A REASON
Few things matter more to patients than presence. Your rounds might be the most crucial part of your inpatients’ days. And remember the ‘force multiplier’ of sitting at their level, rather than looming over them.
HEALTHCARE IS A TEAM SPORT
“Thank you for this interesting consult” snark notwithstanding, a hospital thrives on multidisciplinary cooperation. Respect what other services can do than you cannot. Synopsize the case rapidly and phrase your questions for them precisely.
THE EMR IS NOT THE PATIENT BUT RATHER THEIR AVATAR
I cannot possibly articulate this any better than Abraham Verghese’s masterful NEJM essay on the subject.
WORK HOURS HAVE GOTTEN BETTER (BUT REMAIN PROFOUNDLY ODD)
It’s best to explain to friends and family that for the next 3+ years your calendar will be … unsociable. Even if you miss some holidays and special events, the truly understanding will still be there on the other side.
IT GETS BETTER
Even though we no longer live in the hospital for “residency” it can still feel like that at times. A wise friend told me “every call must end” and that’s true of training as well. It’s a crucible, yes, but it forges confidence and acumen.”
More posts featuring Mark Lewis.
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Challenging the Status Quo in Colorectal Cancer 2024
December 6-8, 2024
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ESMO 2024 Congress
September 13-17, 2024
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ASCO Annual Meeting
May 30 - June 4, 2024
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Yvonne Award 2024
May 31, 2024
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OncoThon 2024, Online
Feb. 15, 2024
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Global Summit on War & Cancer 2023, Online
Dec. 14-16, 2023