Internship and residency, that period of progressive, supervised responsibility, is the special sauce that can turn smart, eager, well-meaning medical school graduates into doctors.
Great story, Austin! It's been over 30 years since I took a night float shift, but this brought the memories rushing back. You are going to be a wonderful internist - hang in there!
I, too, trained at UK. I remember those stretches of nights (and the 6th floor) well at UK Med Center. As an intern, I was struck with the massive weight of responsibility as I would clip no less than three beepers to the waist of my scrubs.
One of course was the code pager. When that went off, Katie bar the door. My heart would sink into my stomach. That’s when I would be thankful I didn’t partake in the cafeteria’s 2am bacchanalian feast of Triple C: chili, chips, and cheese.
But I was trained VERY well. I was an incredibly autonomous physician upon my completion of residency. I miss my days there…what an amazing place to train.
Medicine is fortunate to have you. As a seasoned surgeon I’ve leaned that what patients and their families so desire is genuine empathy and the sense that we are working together to achieve the best possible outcome - they need HOPE! Just that! Best of luck in your journey, keep up the good work, oldsters like me need medical care and we are counting on you!
Great job. It matters so much to project empathetic confidence to patients (even if you do not always feel confident). They feel like you will hear them but also that they can trust you with their lives in a helpless situation.
Good luck with your training. You’ve already got the empathy and work ethic part (stuff that is hard to teach), and your growth in knowledge and experience will layer on top of that foundation.
Night work is where the much ballyhooed “graduated responsibility” rubber meets road during training. Juniors do a lot of it, there’s much less backup, and you learn to make decisions on your own while tired. Those are useful and necessary lessons for when you emerge from the training pipeline and the buck actually stops with you.
Unfortunately…with med schools and residencies so tied up with woke and DEI supervised performance will always be tailored by these weird and destructive….and harmful…ideologies. Like Iran missiles hidden away for future usage these hidden away “ are/will be there awaiting our harmful experience. Merit based training was a strong component of residency training in the 1970s..with the left being so anti- merit we the consumer must be very VERY cautious. Remember, the Speciality Boards silenced all physicians who spoke out against the scamdemic…they have little interest in the truth.
As I contemplate retirement almost 40 years since my own internship I am glad that young doctors like Austin are out there ready to take care of me someday ! Thank you for writing this for us - I wish you great success. And no, we didn't have night float back then , but maybe if we did so many of my colleagues wouldn't be burned out and eager to retire early .
I never did "night float", because night float did not exist, just 36-12-12-36 for two years.
But this article emphasizes something I have said often - it isn't until the hours between 1:00 AM and 5:00 AM in a hospital that the real doctor inside appears - if there's one there in the first place.
I loved this piece. It reflects not only excellent care, but excellent caring. You were present for both of their needs. The moment you describe—the quiet, wordless handshake from a husband who had just endured a night of fear—is something many of us recognize. Those are the moments that sustain a lifetime in medicine.
You wrote this in a column largely devoted to evidence-based medicine—the science of medicine—but what you experienced speaks to the art of medicine. Your presence clearly mattered to that suffering husband in a way that goes beyond EBM based protocols, algorithms, or guidelines.
From a scientific perspective, what you describe likely represented a moment of physiologic attunement: when two individuals come into alignment through shared neurophysiologic responses. There is growing experimental evidence that clinician–patient interactions can synchronize elements of autonomic and endocrine function—heart rate, heart-rate variability, respiration, skin conductance, cortisol, even salivary alpha-amylase. In other words, the connection you felt may have had a real biologic signature. This has been extensively studied in the world of placebo-nocebo science.
Unfortunately, this dimension of care is too often marginalized in today’s highly technical, efficiency-driven world of medical practice. Yet moments like the one you describe remind us why the human presence of the physician still matters so deeply.
As William Osler famously said, “Medicine is an art that uses science… but the art is much harder to acquire than the science.”
Kudos.
PS Your words made me genuinely happy to read. ( PS ask me sometime about my thoughts of being a DO and empathy.....)
Great story, Austin! It's been over 30 years since I took a night float shift, but this brought the memories rushing back. You are going to be a wonderful internist - hang in there!
I, too, trained at UK. I remember those stretches of nights (and the 6th floor) well at UK Med Center. As an intern, I was struck with the massive weight of responsibility as I would clip no less than three beepers to the waist of my scrubs.
One of course was the code pager. When that went off, Katie bar the door. My heart would sink into my stomach. That’s when I would be thankful I didn’t partake in the cafeteria’s 2am bacchanalian feast of Triple C: chili, chips, and cheese.
But I was trained VERY well. I was an incredibly autonomous physician upon my completion of residency. I miss my days there…what an amazing place to train.
Bedside manners;)
Medicine is fortunate to have you. As a seasoned surgeon I’ve leaned that what patients and their families so desire is genuine empathy and the sense that we are working together to achieve the best possible outcome - they need HOPE! Just that! Best of luck in your journey, keep up the good work, oldsters like me need medical care and we are counting on you!
I loved this. The extra caring makes all the difference and also encourages extra thought.
Great job. It matters so much to project empathetic confidence to patients (even if you do not always feel confident). They feel like you will hear them but also that they can trust you with their lives in a helpless situation.
thank you for sharing.
Good luck with your training. You’ve already got the empathy and work ethic part (stuff that is hard to teach), and your growth in knowledge and experience will layer on top of that foundation.
Night work is where the much ballyhooed “graduated responsibility” rubber meets road during training. Juniors do a lot of it, there’s much less backup, and you learn to make decisions on your own while tired. Those are useful and necessary lessons for when you emerge from the training pipeline and the buck actually stops with you.
Unfortunately…with med schools and residencies so tied up with woke and DEI supervised performance will always be tailored by these weird and destructive….and harmful…ideologies. Like Iran missiles hidden away for future usage these hidden away “ are/will be there awaiting our harmful experience. Merit based training was a strong component of residency training in the 1970s..with the left being so anti- merit we the consumer must be very VERY cautious. Remember, the Speciality Boards silenced all physicians who spoke out against the scamdemic…they have little interest in the truth.
Certainly an unusual reply given the nature of the post.
As I contemplate retirement almost 40 years since my own internship I am glad that young doctors like Austin are out there ready to take care of me someday ! Thank you for writing this for us - I wish you great success. And no, we didn't have night float back then , but maybe if we did so many of my colleagues wouldn't be burned out and eager to retire early .
Thanks, Dr Faerber, for your article.
Your patients are better for having had you as their doctor.
I never did "night float", because night float did not exist, just 36-12-12-36 for two years.
But this article emphasizes something I have said often - it isn't until the hours between 1:00 AM and 5:00 AM in a hospital that the real doctor inside appears - if there's one there in the first place.
Austin
I loved this piece. It reflects not only excellent care, but excellent caring. You were present for both of their needs. The moment you describe—the quiet, wordless handshake from a husband who had just endured a night of fear—is something many of us recognize. Those are the moments that sustain a lifetime in medicine.
You wrote this in a column largely devoted to evidence-based medicine—the science of medicine—but what you experienced speaks to the art of medicine. Your presence clearly mattered to that suffering husband in a way that goes beyond EBM based protocols, algorithms, or guidelines.
From a scientific perspective, what you describe likely represented a moment of physiologic attunement: when two individuals come into alignment through shared neurophysiologic responses. There is growing experimental evidence that clinician–patient interactions can synchronize elements of autonomic and endocrine function—heart rate, heart-rate variability, respiration, skin conductance, cortisol, even salivary alpha-amylase. In other words, the connection you felt may have had a real biologic signature. This has been extensively studied in the world of placebo-nocebo science.
Unfortunately, this dimension of care is too often marginalized in today’s highly technical, efficiency-driven world of medical practice. Yet moments like the one you describe remind us why the human presence of the physician still matters so deeply.
As William Osler famously said, “Medicine is an art that uses science… but the art is much harder to acquire than the science.”
Kudos.
PS Your words made me genuinely happy to read. ( PS ask me sometime about my thoughts of being a DO and empathy.....)
Agree, You cannot always control the outcome, but you can control your effort and your attitude.