Friday, June 24, 2016

Navigating Third Year with a Stutter

I always believed my third year of medical school would be the hardest for me.  Ever since I learned exactly what each year in med school entailed, it got into my head that I would be struggling third year.  Third year is the year when you finally leave the classroom and hit the "wards."  The year where you get to be to a functioning member of a hospital team.  The year where you take all the knowledge you tried to cram into your head for exams and boards the first two years and put it to good use.

I tried to plan my year to set myself up for success.  I figured I'd try to schedule the "easier" rotations in the beginning of the year so I could get used to speaking to patients and attendings and end my year with the harder ones, after I had acclimated and hopefully gained some success.

The first half of this year was extremely hard.  It got very frustrating and tiring to hear person after person tell me "we really love you but.."  The but being about the way I speak.  I spent a lot of nights crying to my friend because I was just so frustrated and at a loss at what to do.  Hearing that felt a little worse than the "you are really great but you need to read more" line that a lot of medical students get third year. All I was hearing was "you are really great, but what are you doing here?"  And it just kept happening. And it just made it even harder to speak.

I tried to keep my head up and defend myself and stuttering and gently proclaim that I don't think stuttering will hinder me in any way when I grow up and become a doctor.  Even if every time I had to say that it was through a stream of tears.  But what else could I possibly say?  Because here's the thing, I completely agree I would be a better physician if I didn't have a stutter, but I also have to believe that no matter what state my fluency is in I can succeed as a doctor.  I have to have that faith in myself to keep going, because if I don't I will inevitably trip into a giant crater and be unable to climb out of it.

Then something happened in the middle of the year.  Before my surgery rotation I e-mailed the two heads of the rotation to introduce myself like we were supposed to put in the e-mail how I speak with a stutter but I still can and want to do everything any other medical student does.  That was one of my best rotations.  No one seemed to care about the way I spoke.  I had a lot of talks with attendings and a lot of them said the same thing "I don't care if you stutter as long as you know the information." This was also the first rotation I got to pre-round on patients by myself.  I love pre-rounding.  It was hard and nerve racking at first but then it became my favorite part of the day.  It was much easier to walk into a random patient's room who I had never met before, introduce myself, and ask them a bunch of questions about their bowel habits after doing it a bunch of times. It really helped that pre-rounding was on my own time.  There wasn't any other overseeing body in the room to judge me or step in when I got stuck for a few seconds on a word.  I could stutter as little or as long as I needed to get the word out and it always came out and I always got the information I needed.

I've been told before how I might make patients uncomfortable with the way I speak, or some patients will just not want to deal with it.  I have only had one "bad" encounter with a patient about my stutter.  I was on my psych rotation and was doing a mini mental status exam on a patient in the inpatient  psychiatric unit.  I was trying to ask him the questions for the exam and I was stuttering, and he kept saying "It's just not going to work!! I can't understand you!"  At first I would just say "I'm sorry" and repeat what I was trying to say.  Then he kept doing it and was getting louder and I just had to take a deep breath and strongly say. "I understand what you are saying, I speak with a stutter, but just listen to me." (something along those lines)  And we got through the encounter and it was fine.  One guy.  In an inpatient psych unit. No one else has cared, or no one else has cared enough to my face to kick me out.  95% of the patients I talk to are extremely pleasant and I can usually make them smile at some point during the encounter. People are surprisingly, not kicking me out every time I repeat a few syllables.

I actually had another funny patient experience.  I was doing an admission of a person with a suspected stroke who was having difficulty speaking.  I walked into her room in the ED, started to introduce myself (which is always the hardest part) and she goes "Yeah, that's what happening to me.  I'm having your problem."  AKA she told me I was having a stroke.  I just smiled and nodded my head and moved on and said " what brings you here?"  Then I got to laugh about it later with my friends how a patient told me I was having a stroke because I was stuttering.

Ever since my surgery rotation the majority of the people I met have not cared about the way I speak.  I know part of it is because I am speaking better, my friends and family have been telling me all year how I'm speaking so much better than I used to.  But also I hope my attitude has changed.  I'm no longer hiding behind stuttering, and I'm forcing myself to speak up more.  Especially these last few weeks.  Well first of all, you talk a lot on internal medicine.  And a good portion of it is very low key stuff that was excellent practice, like calling pharmacies to get a medication list for a patient. Or calling in a consult (actually that can be nerve racking if you have to talk to a specialist doctor that you've never formally met before).

But now I am throwing myself into the speaking world.  I bought a car, which involved a lot of talking.  A lot of talking on the phone and in person.  I have also dropped the habit of putting off phone calls to places because I was scared.  I have majorly racked up minutes on my phone these last few months.  The more I make myself speak the better my speaking becomes, the more confident I become, and the easier it is for me to show to my attendings that yes I know my stuff and let me show you.  I still get annoyed/frustrated/a little panicked when I get stuck in stutters, but it's happening less often.  The stutters are less severe.  I haven't had a "stuttering headache" in months and it feels awesome.  I love talking to people, I love talking, and I love that my personality, that often gets stamped out of sight by my stutter, is finally coming to light a little more often.

I like it.  I plan to make it my new habit.