It was a realisation that began with the smallest of signs.
“I was about to start work on a nightshift in the Emergency Department (ED) as an intern,” says the trainee, “I’d eaten well and thought I’d rested enough but as I was taking the handover briefing from the registrar my hand suddenly stopped working.” She noticed her heart was racing and told the registrar she didn’t feel well. “I wasn’t sure what was happening. I thought I’d had an episode of supraventricular tachycardia.”
The registrar sat her down and did observations, confirming a highly elevated heart rate. She was sent home from the shift.
“It wasn’t until a visit to my GP the next day and a gentle question ‘Do you think it might be a panic attack?’ that it dawned.
“At first I felt really embarrassed, everyone in the ED had seen what had happened – they’d know I’d had a panic attack.
“That first shift back at ED was one of the hardest things I’ve done in my life. But acknowledging I suffer from anxiety meant I could deal with it,” she said.
After seeking support from a psychologist, she has now learnt how to manage her anxiety.
“I taught myself to see it was just emotion and not something that was going to stop me from living my life. I learnt to cheerlead myself through a shift by thinking – Bring it on. It can’t kill me.”
On reflection, thinking about her personality and the process of learning to be a physician in the current culture and environment she realised what had happened.
“I have a busy mind and medicine made it busier. The constant studying and learning conditions – you can never switch off.”
The pressures of internship were an added stress.
“Your sleep/wake cycle just goes. I was working long shifts and by the end of a shift, had done so much I couldn’t remember most of it. I would worry after these shifts, questioning my judgment and whether I’d made the right decisions.”
Terms with highly critical supervisors and seniors compounded things for someone who was already hard on herself.
“I often felt inadequate, despite my strengths and efforts, and that I would never be good enough to please these people and meet the expectations placed on me.
“I have experienced a lot of teaching by humiliation. But it has been the supervisors that saw my strengths and believed in my abilities that nurtured me to succeed in my training.”
Things are very different now says the trainee, “I’ve intensively practiced monitoring my own thoughts and feelings. I can tell when my anxiety is being triggered and I have learnt not to take on board unhelpful feedback or negativity around my competence.
“I spend a lot of time in nature. I have pets, I think pet therapy is a wonderful help and I exercise. I start most mornings with a walk on the beach with my dogs. I eat well and minimise alcohol.
“I have also gotten involved in effecting changes in the system that disillusioned me which has given me hope for my career and meaning and purpose in my suffering.”
She’s clear about advice to other trainees. “Seek help. I wasn’t worried about being reported to AHPRA – that’s only for really serious things.”
“No doctor is perfect. We make mistakes, we forget knowledge, and we have feelings and minds that need attending to. Doctors need to be allowed to be human and even embrace this humanness, as it breeds compassion.”
Originally published in RACP Quarterly June/July 2017
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