On July 13, many years ago, he was the very first patient I ever saw on my own.
Working without a net for the first time is terrifying. I'd survived 4 years of medical school, 4 years of residency, and 1 year of fellowship to get there. This is the goal I wanted. And when it finally came it scared the crap out of me.
There was fear in medical school, starting classes and later starting clinicals, and even more in residency. But in both those cases there was always a back-up system- more senior people who actually knew what they were doing. There was also a herd-based support system: You were with plenty of other people, all sharing the same challenges.
But here, after 9 years of training, it was just me and Girard. Even though his case was simple, it's pretty damn scary to realize that YOU are the attending, and if you screw up there's no one else to blame.
I remember another patient that day started the visit by saying "I came to Humungous Neurology because I heard you guys are the most experienced." My inner voice said "you probably don't want to know this is my first day."
Throughout medical school you saw the attending physicians as omniscient giants. Suddenly you're one of them, and realize that they don't know everything. And you aren't a giant.
Like everything else, after a while it becomes routine. But trying to remember that first day still helps to keep you on your toes.
I don't remember how many patients I saw that first day. A handful compared to what I see now. One of them is still with me. I think I told her a few years later she was on my first day. I even got a hospital consult, a lady who'd obviously had a stroke. I got lost in the hospital trying to find her room, then sat in the MRI control room to see images, terrified at the thought that if they were normal I'd have no idea what was going on.
I've now spent an estimated 4,650 days of seeing patients in one place or another, with a lot more to go. But the first one was the scariest. And hopefully always will be.
To all who are starting this July, good luck.