I’ve often heard the phrase, “Don’t bring your work home with you.”  And I used to think that would be an easy thing to do.  And every day before I leave the hospital, I “sign out” my patients to a fellow intern who takes care of them overnight.  Easy, right?

But it’s not easy.  Even if I’m not at the hospital, even if I turn my pager off, I can’t leave my work at work.  Because, unlike other jobs, my “work” isn’t a stack of paperwork or a list of tasks to be completed.  My “work” is taking care of patients.  My “work” involves real human lives, who, even if I leave the hospital, are still sick and still need to be taken care of.

My commute home takes me about 20 minutes.  I turn the radio on and try to unwind and forget about the blunders of my day.  But no matter what amazing song plays on the radio, it is never enough to drown out the voices in my head.  Did I do everything right today?  Did I forget to order anything?  Did I miss anything?

The first thing I do when I get home is tell my husband about my day, which usually involves telling him about a patient I’m worried about who is really sick and hopefully will be okay through the night.  I usually log onto my computer before bed to double check my patients’ charts, make sure all of the orders are correct and that everyone looks stable.

And when I finally lay down for bed I go over and over in my mind the different patients I’m taking care of.  And it’s rare to sleep through the night without having strange dreams or nightmares about my patients.  The other night I dreamt that I went to check on a patient that I was worried I had made a mistake on and the patient shot me in the leg.  Even after I woke up, I could still feel the pain in my leg.

It’s hard being a doctor.  And not just for all the reasons you would think.  It’s hard to be a doctor because you hold so much responsibility.  Your patients’ lives are in your hands.  And that isn’t a responsibility to be taken lightly.

I have always been very hard on myself.  I strive for perfection, and I beat myself up when I make mistakes.  As an intern this trait can really take its toll on me.  For example, I had an experience where I ordered a very important and time sensitive medication for a very sick patient.  Hours later as I was discussing the patient with my attending, we realized the medication had yet to be given.  I wanted to so much to blame someone else.  Did the pharmacist change the order?  Why didn’t the nurse give it?  I was so angry.  Who was responsible for this error?

And it sucks to realize that no matter what happens, I’m responsible.  It was my patient, so it was my responsibility.  I should have followed up on the medication.  I should’ve double checked the chart or called the nurse or gone and looked in the patient’s room.  No matter how much I want to complain and blame someone else, I am the one who messed up.  And it kills me.

It’s so hard to let things like that go.  This is just one example, but there have been little things here or there that just eat me up inside.  Things I can’t forget.  And even if I relive the situation over and over and figure out what I could have done differently, or realize I did everything right, or convince myself it wouldn’t have made a difference in the outcome, I can’t just let it go.  I can’t just leave my work at work.  My patients follow me wherever I go.  Because no matter what, my patients are my responsibility.

About emilyehoward

My name is Emily, and I am a Hospitalist in Nebraska. I live with my husband and three beautiful daughters. I hope you enjoy my blog!
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