Now I see why this is Tough.

My emotions have been riding high over the past few days. And sadly, it isn't from seeing sick/comatose patients lying shrivelled up in their cots.

It is the combination of sheer stress from being unable to meet other's expectations, the burden of having responsibility over other human lives that weighs heavily on my shoulder. The fear from being seen as incompetent/lazy/inefficient/stupid keeps me up at the crack of dawn while the rest of my family snooze away in their beds. My heart literally flutters at the thought of leaving my house late and not being able to get onto the ward on time to finish my pre-round before the MO and Consultant arrives.

This is the unpleasant predicament that faces every Houseman. A prolonged period of chronic stress and anxiety, one could blame it all on having a license to kill.

I am struggling to keep up.

To stay on the same page as my Consultant as she rattles through the plans for each patient as I scribble furiously on the column of each page, trying not to miss a single word she says.

TRO HBS? KIV OGD? TCU SNEC? ARU 2 BPH? SP IDC? IHD S/P CABG?

The local abbreviations they use here seriously throw me off my feet.

I have been unable to answer all her questions. Questions about the patient's past medical history, medications and doses, social situation and family background and lab results. Even basic clinical medical questions get answers pitched in from the bystanding medical students. Answers to simple questions I should know. Literally answers of the kick-yourself-in-the-shin-because-its-so-damn-obvious kind that I should know. Should know.

The criticism and the sense of frowning disapproval I get from my current Consultant that really puts me down after a hard day's work. No matter how hard my MO has seen me try, there always seem to be a loophole I've missed that gets picked up by the Consultant, who would proceed to berate me for my negligence and lack of ''thinking going on inside that brain of yours''.

Will I ever be able to do anything....anything that would earn her stamp of approval?

''One more time you repeat this same mistake I shall lose my temper with you.''

I feel like the world's most useless & dumb dumbest damned idiot.
(is there such a word as Dumbest?)

Ever so often, it takes a sense of optimism and altruism to fend off every negative thought that plagues my mind.

The desire that God will use me for a purpose. Any purpose.

That God got me through medical school even when I didn't even deserve to pass finals.

That medicine was meaningful. And a brilliant way I could reach out to non-believers.

Any thought.
Any positive purpose to my lowly and unworthy existence.

Anything that would mute the sinister, pessimistic voice tells me that I don't deserve to be a Doctor because I will never be good enough to do anything useful for my patients.

It is hard to pull a straight emotionless face through the day. But I have to keep trying. And ocassionally keep smiling.