The Hump

One of the most memorable lines for me of Starship Troopers (Robert A. Heinlein) was the description of "the hump", as below - in a letter from an old trooper to a recruit in boot camp :

You are now going through the hardest part of your service -- not the hardest physically (though physical hardship will never trouble you again; you now have its measure), but the hardest spiritually . . . the deep, soul-turning readjustments and re-evaluations necessary to metamorphize a potential citizen into one in being.

 and then later on,

The noblest fate that a man can endure is to place his own mortal body between his loved home and the war's desolation

Starting to come into my own as a house officer, feeling more comfortable in my role - I've been pondering this metaphorical hump.

Do I think this hump exists in the trial-by-fire that is internship?
Yes. Well, probably.

... deep, soul-turning readjustments and re-evaluations neccessary ....

Far more valuable to me than the medical knowledge and practical experiences that I've gained, is the attitudes and ethos of being a house officer, and by extension, being a medical professional - a "real doctor". I've being fortunate enough to be in a team where strong role models abound, and can watch, and think through what it means, to me, for me, to be a (dare I say it?) good doctor.

"Do not dump on your colleagues" - get your patients sorted - make sure that everything in the plan has been arranged, tie off all loose ends as much as possible so that the after hours/night doctor does not have to pick up the care of your patient.

"Own your patients" Know them, talk to them, track their progress, chase all the results and follow them through... this is the most rewarding thing about medicine, being able to see improvement with what your team have put in place

"If in doubt, ask" and ask the appropriate person in the right manner and right time. This is perhaps the most difficult thing for me to do - I'm still reluctant to call anyone, no matter how simple, or urgent... but I am improving (if only due to the fact that I have to refer/get opinions/consults every day) through practice.

"Help each other" Doctoring is hard, long, sometimes thankless - but the support you get from and give to your colleagues is priceless. Be it teaching a junior, or sharing drinks, or just offering to do jobs, offering a shoulder to cry on... So many little things. And its not just doctors, it is the whole team, including the ward clerk, the nurses, physio, OT, social worker, dietician, pharmacist, etc etc etc.



... to metamorphize a potential citizen into one in being.

Or a potential doctor into an actual doctor.
Some of my seniors vouch for the time where things just "click" - where being a house officer goes from new, hard, different - into something almost routine; getting into the groove of knowing what to do, and knowing who to call when you don't know what to do.

I personally feel that this metamorphisis will probably take years; and the learning curve will level off at times and be almost ninety degrees at times. And its just part of life, and the job.


"The noblest fate that a man can endure is to place his own mortal body between his loved home and the war's desolation"

Time, sweat, tears, fatigue... combating illness, fright, sadness, grief - and sometimes, false hope.
We ain't magicians - but we can sure do our darnest.