Thread by @TheRealDoctorT

It’s 2002.

“How You Remind Me” by Nickelback is the #1 single on the Billboard charts.

I’m a third year medical student, unleashed from the safe confines of the lecture halls into the wilderness of the hospital floors.

I’m half-excited, and half-terrified. 1/

The attending physician for the medical team I’m assigned to has a reputation. He makes medical students cry with the severity of his questioning.

He’s a brilliant man, but merciless.

He’s exactly who I DON’T want as my first teacher.

And today he’s grilling me. 2/

I have haltingly gone through my patient presentation, filled with the kind of unnecessary detail and missing elements that are characteristic of a newbie.

He pounces on each and every mistake, dismantling my self-esteem in front of my colleagues.

But I don’t cry. 3/

He asks me a tangential question and I’m thrilled that I can actually answer it, I remember this one! He seems irritated at my success, and then proceeds to grill me on the specifics of the Schilling Test.

I... I ... should know this. But... nothing.

My mind is blank. 4/

He leans in close, and I’m startled by how red-faced he suddenly is, as he screams at me. “GET YOUR ACT TOGETHER AND STOP WASTING OUR TIME!”

He slams the patient’s chart shut and the sound is like a gunshot.

It makes me jump.

He looks away, disgusted.

I feel sick. 5/

After rounds I make my way to the bathroom, feeling my heart thundering in my chest. I lock the door, lean over the toilet, and throw up violently.

I retch until there’s nothing there. As I flush and look at my face in the mirror, my vision is blurry with tears. 6/

I’m wasting everyone’s time. I think of my dad who sacrificed so much, driving six hours a day so I could stay in the same school district. I think of my mom, who home-schooled me when we were abroad.

The tears flow freely now. I’m so sorry to all of them.

I am a failure. 7/

Above all else, I hated the feeling of being dissected in front of my fellow students. Of having the spotlight shone on me, and having all my faults laid bare. Of being the example of what not to be.

Even typing this tweet is making me feel queasy. 8/

I catch my breath and wash my face.

Enough.

I didn’t come this far to flame out in the first week. My despair is replaced with a sudden burning rage.

I’m quivering with fury.

How DARE he?

ENOUGH.

I storm out of the bathroom and straight into my chief resident, Alice. 9/

Alice is universally loved. Years later she will become an acclaimed cardiologist on the faculty and win many awards.

For now, she is the chief medical resident.

She takes one look at me and says “follow me.”

We walk together to a deserted charting area and sit down. 10/

“Rough day, hmm?” She asks the question understandingly, leaning towards me, her gaze kind and attentive.

I’m so grateful.

The events of the morning spill out of me like a burst dam. She listens to my breathless retelling without interrupting, her brow furrowing. 11/

When I’m done, she speaks simply and clearly.

She says three things.

I’ve never forgotten them:

“I’m so sorry, Sayed. That won’t ever happen again. You belong here.”

And with that, our conversation continues until work intervenes.

I feel completely renewed. 12/

Alice is true to her word. I don’t know who she talked to or what she said, but the merciless attending quiets down.

Amazingly, Alice shows up at our rounds now and then. It isn’t her job, she’s super busy as chief resident, but she sits in all the same, supporting us. 13/

Whenever Alice is there, things go super smoothly. When she isn’t there, it gets a little scarier, but no more slammed charts or yelling.

She was so busy that day, but she saw me, with reddened eyes, and immediately made time for me.

Fate brought her to me in that moment. 14/

So many of us never have an Alice there at just the right moment.

Medical education, and many other environments for that matter, have often been needlessly toxic.

Did I learn better from that attending? No, I STILL don’t know the details of the Schilling Test. 15/

Be an Alice for those who need you. Support each other. And fight the toxicity.

I know people have had similar experiences from toxic instructors. And I know students can be toxic to each other and to instructors too.

Fight it.

You’re not alone. 16/

I’ve had people tell me, “well, stress is necessary to learn. You need to toughen up. Be stronger.”

I don’t remember a single thing that man taught me. Not even the Schilling Test.

But I remember every lecture Alice ever gave me.

I still try to emulate her example. 17/

There’s a difference between being demanding, and being cruel.

There’s a difference between being exacting, and being cruel.

There’s a difference between having high standards, and being cruel.

You can be stern, firm, exacting, all without cruelty.

Don’t settle for cruel.