Thursday, May 26, 2011

Michelle Au's "This Won't Hurt a Bit"

Michelle Au graduated from Wellesley College in 1999, received her M.D. from the Columbia University College of Physicians and Surgeons in 2003, and completed her residency in anesthesiology at the Columbia University Medical Center in Manhattan. She is married to Dr. Joseph Walrath, has two sons, and lives in Atlanta, where she is an anesthesiologist in a private practice.

She applied the “Page 99 Test” to her new book, This Won't Hurt a Bit: And Other White Lies - My Education in Medicine and Motherhood, and reported the following:
From Page 99:
“How do you do it?” I asked my intern once when I was a third-year medical student. I was watching her juggle twenty-five patients, a ceaseless stream of urgent pages, three simultaneous emergencies, all while drinking a full cup of coffee without spilling a drop. She had at this point been awake for the past twenty-seven hours.

“You just do it,” she answered cryptically, one-handedly typing a note into the computer while picking up the phone to answer her latest page. At the time, I didn’t really understand this philosophy, which I had heard from several other residents before—chalked it up as one of those nonsensical sayings like, “It is what it is,” stemming from a culturally saturating Nike ad campaign. But when I started my sub-I—started being on the receiving end of those endless pages, the first person called in an emergency, realizing that for the first time, I was not simply a passive observer or an extra set of hands but actually responsible for these patients under my care—I got it. You just do it. You can’t think about how much there is to do, or how much is going on, or how tired you are. There’s no time for that. So you just do it. You put your head down and get to work, and at the end of the night you look up and realize that you got through it all. And then you go home and come back the next morning and do it again. This is what I am learning from my sub-I*. I am learning that I can do this.

Most of the time.

*sub-I stands for “subintership” which is a requirement for med students to graduate. It is an internship working for a first year resident (usually referred to as“interns”).
I do love the dropping into a story in media res, and I think that this is the perfect place to sample from the book, and highlights one key theme, which is that people training in medicine find themselves eventually able to do things that they didn’t think they would be able to do before they started.

You never quite feel ready to have the responsibility of taking care of patients on your own, but at some point in your training the moment comes upon all of us to sink or swim. And almost all of us, sometimes to our own surprise, find that we can swim. It’s that moment that you realize that, the first moment that you see something happening and make a clinical decision and act on it, all on your own—that’s the essence of learning to become a doctor.

It’s that kind of instinct that is the essence of becoming a parent as well, and though this particular excerpt on page 99 doesn’t get a chance to get into that, it sets things up for later in the book, where the story expands to how I try to juggle having a baby and being a medical resident at the same time. How, with two equally and completely consuming jobs, does one decide which to prioritize in any given moment? How are you supposed to “do it all”? Same way as you did before. You keep your head down, keep your eye on what’s important, and take care of what you need to do. You just do it.
Learn more about the book and author at Michelle Au's website and blog.

--Marshal Zeringue