Getting Uncomfortable #12: Becoming Something Else - Growing Pains Management
A new doctor's story of career growing pains and lessons to apply to any career journey
This Book Got Me Out of Bed
As my son pulled me through Barnes and Noble like Sonic the Hedgehog, headed toward the Legos, I snagged a book on the “Must Reads” table. It was one of those lucky draws, the kind that remind you how one book can change you, make you feel seen, how someone can put into a story, completely unrelated to your path, what you went through to become something else.
Earlier this year I read Lessons In Chemistry by Bonnie Garmus. I doubt I’ll beat that book as the one that touches the deepest parts of my career journey, but this one is a close second. The 1978 The House Of God by Samuel Shem got me out of bed this week. It’s a smart, complex, raw story about a first-year medical intern at a hospital dubbed “House of God,” and any underlying connection between the title and religion is left for an essay assignment not included here (a discussion on the status of men and women in the workplace in 1978 also not included). This book is full of sex, bodily functions, death, love and the uncomfortable extremes we go through to survive the transformation to be whatever we said we wanted to be when we grow up.
Enter The Tunnel
Shem takes us on a ride with Dr. Roy Basch, the medical intern and hero of our story, as he steps into a year-long water slide tunnel, trying not to drown in all the twists and turns and rug burns of becoming a doctor. I recommend this book to anyone who is a doctor or is thinking about becoming a doctor or has ever had a doctor. The general themes are applicable to any career journey — a grown-up, R-rated Oh, The Places You’ll Go, the stuff they can’t teach you in school that you have to see for yourself. Not every journey will have such high stakes as keeping people alive, and Roy’s journey is certainly not as much fun as a water park, but I bet you can relate to how it feels to get squeezed through the tunnel of learning to splash out at the other end, smarter, possibly jaded and a different version of yourself, looking for the reward of survival and maybe ready to line up for the next adventure.
Becoming Can Hurt
The purpose of transformation is change. You’re supposed to be different, better, more useful after an internship or training program. Roy’s journey reminded me of several transformational experiences in my career.
Sometimes, in these experiences, I was a mangy, stray dog moving along on a conveyor as I was washed, groomed, taught to fetch and sit and ready to live at a cartoon mansion at the end. Other times, I felt more like an innocent child in a clean frock, wearing a book bag and a willing smile, entering the woods full of monsters, learning how to hunt, golf, shoot whisky and smoke cigars. My clean frock torn to pieces to bandage bloody wounds. In bear grease camouflage, heavy armor and grass sandals, I emerged a hardened, badass, boss lady version of myself.
This book is a cautionary tale — be careful what you want to become; you might actually achieve it. Sometimes you end up the clean, rich dog and sometimes you’re the hardened kid, wondering how best to use your newfound toughness while coping with mental reels of nightmare fuel. (On the plus side, you’ll be ready for parenting.)
The Brave Start Learning
As his internship progresses, Roy gains skill and confidence by taking risks and making mistakes caring for patients. He begs the question: what’s worse — the fear of doing something or figuring it out while you’re doing it?
For most, the fear is almost always worse. We spend anxious energy imagining how poorly it will go or thinking of the ways we will get it wrong and what it will feel like to be wrong. Staying at a Holiday Inn Express won’t work. The only way to learn is to do it — right, wrong, messy or otherwise. It’s called “practicing” for a reason. Roy steps up and makes decisions in the chaos, wielding needles and knives and pharmaceuticals with limited guidance. He says taking risks to treat patients “pinned down my terror and exploded it to bits.”
How great is that description? Action, the ultimate fear fighter.
Bravely, he took back control from his fears and eventually moved to the top of the ‘terns. Roy says, although a doctor’s job appears to be saving others, what he learned in taking risks to save others was “how to save myself.” Sink or swim, and so poetic. Cue Fray’s “How to Save a Life” and any of the early seasons of Grey’s Anatomy, before it became immortal like Days of Our Lives.
Shem illustrates the many ways people handle the same hard journey to transform, some better than others. Roy and his friends escape and numb with alcohol, drugs, sex, sarcasm, making legally questionable decisions, clinging to excessive exercise, repressing and steeling feelings to avoid the pain and worst-case, jumping. Some coping mechanisms have devastating results. Others have a long tail with a one-way ticket to therapy.
Having courage to make mistakes and learn is one type of bravery. Dealing with your feelings requires leveling up. Roy learns that feelings are a bitch, and if ignored, they grow like mushrooms in the dark. Shem shines a light on the consequences of and tendency to harden ourselves, to become steel so you don’t feel.
It’s easy for Roy to blame others and blame the system. Surely, there are some things needing overhauled in any profession, but the employee/employer relationship is not perfect. Roy tells Fats, his favorite trainer, that the House of God can’t run without him and the other interns. Fats tells Roy, “Externalization is a brittle defense.” He explains externalization as “Seeing the conflict as outside of you. The problem isn’t outside of you, it’s inside.” Roy must figure out how to acknowledge and work through his feelings to salvage his humanity.
All You Need is Love
Roy’s girlfriend ultimately helps him feel his feelings and saves him. In hindsight, given the hard-core nature of Roy’s internship, I’m only slightly surprised that the saving theme in this book is love. His romantic partnership is a savior, albeit it hangs in balance during most of the book, but it’s also his deep friendships with colleagues and the trust he places in his mentor, Fats, whose light-hearted attitude, “do nothing” advice, questionable acronyms and wisdom deliver Roy from despair. In today’s terms, we might say Roy was losing his sh#t. Fats knows how to balance humor and empathy while saving octogenarians with bowel issues. (There’s a lot of poo in this book.) He also sees the potential in Roy and helps clear a path for him to save himself.
It does matter that someone at work cares about you and supports you, even if your job is to care for many others. Doctors (or insert your profession), even at the highest levels, have feelings and need other people to love and care for them and understand what’s is truly like to make those decisions every day. It’s what makes us all human.
Out The Other End
This blog was part book review, part mirror of what it takes to become a professional whatever-it-is. Roy shows us that becoming something else takes courage, vulnerability, endurance, love for yourself, love for what you’re accomplishing and love for and from others along with you. Transforming can hurt while you’re doing it, but it can ultimately make you a better version of yourself if you’re not afraid to manage growing pains in a healthy way. You’ll have more to give and be less afraid to live. No one can take away your experience and journey; it’s all yours — bear claws, blood, whiskey, impacted bowels and all.