1) Shattering ones own confidence 2) Reading

I had been feeling pretty confident lately. In fact, recently I've had a few conversations on how a few of us in our program have hit that stage where we begin to feel like we do, in fact, know a few thingsThat's the tough part about acquiring knowledge, especially medical knowledge. It's impossible to explain what you know. Sure, you can recall some stuff off the top of your head. But in a larger sense, a large part is the application of knowledge. We residents tend to spend a fair amount of time looking things up. And not just looking up, but also printing up stuff to read "later." Like later when I'm bedridden in a nursing home, because that's likely about to be the next time I have leisure time to read.

Tonight, I have decided to throw away all the stuff I haven't read in the last 2 years. (It's a fucking shame there is no recycling in my area. I'm killing trees here)! It's haunting to see the vastness of knowledge I am throwing away. I feel like, OH MY GOD, I DON'T KNOW JACK SHIT LOOK AT ALL THIS STUFF I HAVE NEVER READ, I AM DOOOOOOMED! (The corrolary to this is: OH MY GOD, I DON'T KNOW JACK SHIT LOOK AT ALL THIS STUFF I HAVE NEVER READ, MY PATIENTS ARE DOOOOOOMED!)!

Sometimes I want to gag when I hear the term "Lifelong-learning." I thought I was signing up to learn the bulk of stuff during residency and then do some little learning here and there, preferable at medical conferences in nice hotels, surrounded by ski slopes or warm sandy beaches.. but the closer I get to the end of my residency, the more I realize that residency is preparing me to 1) Not kill people 2) be able to treat the bulk of patients, and treat to a minimal-moderate standard 3) know when to call in backup.

As for reading... between the 4-6 journals a month that I feel compelled to try and read, plus the shit I print regularly, plus the books/study guides for that months rotation, plus the few pedi books that we recommend to parents, plus the stack of books that have nothing to do with medicine, but are a nice escape, I need about 5 more hours in a day to read. Remember when you read a book and had to do a book report in junior high. You wanted to mention some small specific details from the middle of the book so that the teacher knew that you actually read the book. That's how I use to feel about journal articles.. now I read the beginning and the ends.. the boring shit is in the middle... who cares what the delta co-efficient raised to the sputum power of the random blah blah blah... I need to now the level of detail so that I 1) Don't prescribe a drug that will kill somebody 2) can stay current on treatment guidelines so that I can give the best care possible to patients, and 3) what what drugs the back-up docs are using so that when the patient comes back to me from the specialist, I don't look like a fool.

No wonder I almost need bifocals.

Cheers,
I'm off to read.

Brian