Dear new intern:
As you embark on a year that will prove at different times stimulating, frustrating, rewarding, and exhausting, you’ve likely already been inundated with suggestions on how to thrive, or at the very least, survive what lies ahead.
While I have no pithy advice or intern life-hacks to offer, I suggest one (perhaps strange) practice I hope you will consider and strive to exhibit as you weather the highs and lows of the tumultuous year before you: that of extending hospitality.
There is an irony that you may not have yet detected but are sure to soon witness firsthand: Hospitals are some of the least hospitable places around.
It wasn’t always this way. The original hospitals, termed “xenodochia,” arose in Roman antiquity and served as places where local monks tended to weary and ill travelers on pilgrimage. This word is literally translated as “house for strangers,” with the same “xeno” root we hear trotted out when describing fear of foreigners today. The fundamental ethic of these institutions was not fixing or even temporizing pathology, but rather an emphasis on an unconditional welcoming and openness to strangers.
As July 1 nears, I urge you to keep your eyes peeled for these strangers. Sometimes this will be you, finding your way in an unfamiliar (and perhaps intimidating) place; more often it will be others. Yet regardless of who (or where) these strangers are, they yearn for a welcoming that can be elusive in the cold corridors of the hospital.
Consider the familiar scene you have likely already experienced as a medical student. On the first day of a new rotation, you enter a workroom where seven strangers with white coats sit hunched at various workstations. No one looks up. You shuffle toward the open computer and sit down to log in. A bleary-eyed white-coated person to your right turns and says, “That’s where Steve sits.” Unsure of who Steve is and beset by shame, you look around, slink to a chair in the corner, and pull out your laptop. As you continue to sit, your heart races and stomach churns as you seek to find the attending you are supposed to be working alongside. He enters, sits down (you furtively confirm this by stealing a peek at his badge). You introduce yourself. He tepidly responds, “Oh, I didn’t know I had an intern today,” before asking you to slip in and see room three. “And do you have a template to use?”
I don’t mean to be bleak, but you are sure to experience this feeling countless times as an intern in a new place, working a new job. The frustration, social fatigue, and frank anger you feel may engender resentment. Your predominant thought may be, “I cannot wait until this is over.”
But it’s precisely at these moments I urge you to lean in, to pay attention to what you are feeling, and to consider the opportunity for growth here. Store away how you feel in these moments, not with a sense of anger and sanctimony but one of intentionality. Before you know it, you will be the person with the opportunity to extend welcome to strangers in a strange space, to allow them to feel as if they are welcomed rather than an imposition.
You will have this opportunity with medical students and fellow health professional workers who will look to you as leader this year, whether you feel that way or not. Consider how far extending even the smallest gesture of welcome will go—asking their name, where they are from, showing them how to log into the computer, offering a cup of coffee.
If you start practicing this now—offering yourself to others in small ways, without the need for recompense—you will be surprised at how much more pleasant your work environment will become. When others feel valued and seen, we move from acceptance—when one’s presence is merely tolerated—to belonging—when one’s presence is literally desired—longed for. If you commit to this practice, when you become a supervising resident soon, you will learn to look at your role as one that is infused with the opportunity to make others feel welcomed, feel known, and feel like they matter.
Importantly, this practice shouldn’t be confined to your fellow health care workers, as you should strive to remember the ultimate strangers you are privileged to welcome every day: your patients.
If you’ve ever been sick, you may know the feeling of being rendered a stranger to yourself as your body seems to betray what you have come to expect from it. Consider your patients, for whom this self-estrangement is compounded by literal displacement. As they sit before you in a hospital-issued gown, the very place where you are said to “reside” robs them of their particularity; of their homes, their stories, sometimes even their names.
While intern year is hard, and you will face constant challenges in caring well for these patients—particularly the “difficult” ones among them—please don’t lose sight of the daily privilege you have of making the sick and frightened you care for feel welcomed, and known.
Again, this doesn’t take much. Knock when you enter their room, rather than barging in. Ask their name and their loved one’s name. Ask where they are from and what they spend their time doing. Tell them that while you’re sorry they are sick, you’re grateful to participate in their care. You will be surprised at how little this requires of you and its power to transform what often feels like a sterile and extracting patient-physician relationship to one that feels more like friendship.
I realize this focus on extending hospitality may strike you as odd, overly sentimental, or wholly unnecessary, which is OK. But with time, if you pay attention, I hope you might notice and even seek out these moments when you can come alongside and extend a welcome to a co-worker or patient and make the shared space we occupy a little less strange.
Benjamin Wade Frush is an internal-medicine pediatrics resident.
Image credit: Shutterstock.com