I’ve just experienced one of the most embarrassing (not worst patient outcomes, just down to the core of my doctor-ego embarrassing) moments so far in my academic career. I need some positive reinforcement, honesty, and maybe reassurance that maybe it wasn’t as bad as it felt. Here’s the backstory… I wrote MiM about a year ago when I was trying to decide between a fellowship application to Endocrine or applying for the Chief Medical Resident position. I got some really helpful opinions and turns out I got the Chief job and will be putting off fellowship for a few years, probably with some hospitalist work in between. I also, in the meantime, got pregnant again and had our second child. It was all part of the grand plan to get as much paid maternity leave as possible before the bubble of residency is over and to spend more time with my new baby as I could, because chief year was supposed to be more flexible than being an attending... Plus, I’m already super tired and overworked, might as well just do it all now… right? It doesn’t get any easier? (this is my rationale… flawed as it may be)
So now baby boy #2 is 3.5 months old, older boy is 3 years old. I’ve been on maternity leave for 8 weeks, and then research for 8 weeks. It’s been blissful bonding time with baby boy #2. Now I’m coming up on the end of unstructured time in residency… and today I presented my research at the resident research symposium. I only had to get some slides together to fill a 20 minute time slot with my results. Pretty simple. Not presenting at ACP or other Fill-in-the-blank Big Subspecialty Conference. The slides were good and I had some positive results. Problem is… my brain is not what it was a few months ago. I haven’t had to interface with a lot of people at work in MONTHS. Major clinical rotations were done for me over 6 months ago. Let’s face it: I have Baby Brain and this phenomenon is real. With my first son, I started intern year when he was 4 months. So okay, I had an excuse for not knowing anything then, because no intern really knows how to do their job in the beginning. What’s my excuse now? No one really remembers that I just had a baby 3 months ago. Or that this is my first real public presentation outside of my data crunching at home.
So here’s what happened tonight and why I can't stop crying. Okay, that part is likely hormonal. But I am honest-to-goodness downright embarrassed…
My slides went well. People were impressed with the findings. Then came questions. I am not a fan of public speaking on a normal day, but now I felt like I was having an out of body experience. I could not think. Initially, I was able to say “yes, good point, that would be an excellent idea for future study… blah blah blah” Then the Chair of Medicine asks a question. In hindsight, he was prompting me to recall part of the lipid metabolism mechanism which may explain part of why my research finding was the way it was (without getting too detailed). I couldn’t come up with anything. My program director then tried to prompt me again to answer with a knowing sparkle in her eye. She practically winked (may be an exaggeration). Again – MIND BLANK – nothing… I asked him to repeat the question. I couldn’t even come up with filler. It was like the dream where you are naked at school. “uh… uh…” That’s all I could say. I couldn’t believe it. I thought I was going to vasovagal right in front of everyone. Saddest thing is, I knew the answer; I just couldn’t recall the words. Maybe I had a TIA. Nah… it’s baby brain.
The worst of it: My next major work project is… presenting GRAND ROUNDS for the medicine department. In 3 weeks. It’s a tradition for all the incoming chief residents in my program to present grand rounds and I have been preparing, stressing, and thinking about this for 6 months. But now I’m downright terrified. I’m so scared my brain is going to fail me again and leave an auditorium to fall silent to simple questions that I should know the answer to. Here I am people – the new face of our Big Academic Internal Medicine Program.
I need my brain back. There are so many patients I need to care for, medical students to teach, a residency to effectively run, and the ABIM to pass in a few short months… I need it back. I need to know that I can still do this job.