Editor's Forum

The Necessity of ‘Paying It Forward’

My first month in the emergency department was near the end of my third year of med school.

Thuy headshot.JPG

Although I had experienced the controlled chaos a few years prior as a scribe, my initial steps in the ED were filled with trepidation. I wasn’t sure I would be ready to build a comprehensive differential with such limited information, especially for those patients whose primary surveys were borderline or not at all intact.

Pivotal in the development of my early gatherings of knowledge and clinical acumen — and, ultimately, my love for emergency medicine — were my attendings and fellow team members, from whom I learned invaluable lessons during that crucial month. From bedside manner, including actively listening to the patient rather than furiously taking notes, to my first fascia iliaca block where the hydrodissection was almost as satisfying as the patient’s pain relief, the consternation I felt before each shift slowly transformed into excitement.

As I progressed through that month, my subsequent sub-internship, and later an ultrasound elective, my aptitude and resultant confidence increased with each week. I was pulled into rooms with interesting clinical presentations, given the opportunity to apply my growing ultrasound knowledge, and guided through procedures by residents, attendings, and nurses who knew I was eager to learn as much as I could.

Years and countless patients later, those who helped me along the way have left a lasting impression. I’m beyond grateful for their enthusiasm for teaching, and for their willingness to engage me in learning opportunities.

Reflecting on these magnetizing experiences of my past, the good fortune I’ve had to learn from my current attendings and co-residents, and the contagious enthusiasm of medical students who may pursue pathways into emergency medicine, some of my reservations regarding the future of our specialty are assuaged.

One of the many strengths of an emergency physician is the ability to swiftly establish rapport. When we combine this affability with the breadth of conditions we diagnose and treat, there is endless potential to engage medical students during their ED rotation and perhaps demonstrate how fulfilling it can be to care for anyone, anything, anytime.

I understand the challenging practicality of prioritizing medical student education along with ever-present, everyday demands — not to mention the delicate balancing act of juggling extra tasks on top of serving as senior resident of a pod, responding to resuscitations, and dealing with innumerable interruptions throughout the day.

However, all of this does seem less insurmountable when I force myself to pause and acknowledge the gratitude I feel toward attendings, fellow team members, and mentors along the way — all of whom took more than a few moments to ensure I truly understood, and appreciated, the medicine I now practice. Through the lessons they taught and examples they set, they have shown me the importance, the value, and the joy of paying it forward.

So, while it sometimes may be difficult to visualize the precise future of our specialty given the current climate, I am doing my best to focus on the things I can control — and that includes serving as a source of information and motivation for today’s medical students. Experience is often touted to be the best teacher. But sometimes, we — as residents in the midst of our training and in the early stages of our careers — can choose to be the best teacher.

Thuy Nguyen
EMRA Secretary/EM Resident Editor-in-Chief

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