"How do you think you're doing?" the attending asked me. It was time for midpoint evaluations and I answered in a way that I've never done before. I did not hesitate and responded in one word "horrible." I then began to methodically list off all the ways I was not doing that I've always done in every other previous rotation. If you ever need a letter of recommendation - Will make a wonderful addition to the house staff (meaning I'd be a good attending) - Will make a phenomenal doctor - Have you done this before? These are the evaluations I am used to receiving. But at the end of the day, they don't matter because I'm the one who has to look myself in the mirror. My own opinion of myself has always mattered more than any one else's as long as I can remember. Maybe I have a touch of narcissism in that regards.
The attending agreed with my assessment but tried to be more positive and encouraging. This is pediatrics, after all. They're very nice people as far as rotations go, probably the nicest actually. The attending knew enough of my story to know I was wrestling with things far beyond this hospital and asked what they could do to help. This was my battle alone and I turned it around. "What do you want to see from me to change my final evaluation?"
And what the attending said will stick with me for awhile. It's one thing to think something about yourself. It's quite another to have a person who really doesn't know you lay it out as plain as day.
"You are capable of so much more. When you are on, you are on....you are better than a lot of first year residents. You present the patient like you're reading my mind about what I would ask next. But there are so many times when....you're just not here. It's like you're somewhere else. When you're here, I need you to be here. Does that make sense?"
Do I understand? Absolutely. Is that easily done? Not a chance.