Impostor

For Planck, and the Physics-ian

I love it when I have a patient who talks to me about Physics. “Quantum physics, now that’s really just another explanation for the soul,” he added.  I nodded my head.   “I never felt like I got enough Physics in College,” I lamented to him.  “Me neither,” he replied, and went on to outline some recent findings about Neutrinos that travel faster than the speed of light.  My curiosity, long suppressed by trying to cram More Facts into my head, awakened.  I remembered the wide-eyed wonder of the world split open, looked at through a hundred different glasses, tiny colored pieces of light falling together into a giant Mandelbrot set.  Philosophy, poetry, Chemistry.  Always feeling the truth is out there for the honest seekers.  Physics.  I love it when patients talk to me about Physics.

Except that I don’t.  Because there’s someone in front of me who might be as smart as me.  He likely has the internet at his house.  He knows about his meds and doses.  He tells me he wants a higher dose of testosterone.  I assume they make it in a higher dose, but I don’t know.  I’ve never prescribed that medication before.

There are a lot of things I don’t know, actually.  Turns out I can’t ever spell amitriptyline without looking it up.   I’m pretty honest about what I know and what I don’t know, to the extent I can still manage to keep my patient’s confidence and my colleague’s respect.  It’s such a balancing act, though. 

And some day soon they’re all going to find out that I had to look up cervical radiculopathy treatment.

In medical school I complained to my classmates when a test was difficult, expecting them to commiserate.  They didn’t.   I felt stupid.  Turned out I did better than most of them. But I didn’t know about the game we were all playing, called “Act like you know what the f*ck you’re doing.”  If you don’t know the answer, don’t tell people that, of course.  What was I thinking?

So I learned.  And when I was an intern it was approximately the opposite.  I held on to my doubts, and folks told me I was doing great.  I smiled and nodded, and panicked on the inside.  One day soon they would realize I don’t know anything and fire me.  Then I’d be done.

But I wasn’t done yet.  I finished the whole darned residency.  And here I am.

Today I printed off the ASCCP guidelines.  Again.  Because not only do I not remember them, also I lost the copies I had.

Also, which one is Diovan?  And what’s the highest dose of that?  And how do I know if someone has Sjogren’s syndrome?  And why does this 15 day old kid have conjunctivitis?  And what do I do about galactorrhea?  And is it ok to take Trazodone and amitriptyline and gabapentin together?  And OverActive Bladder.  Is that even a thing?  (Still not convinced).  By the end of the day I had 6 AAFP articles pulled up and 2 up-to-date articles all on my desktop. 

Soon everyone will know what a fake I am.  They’ll figure out I really don’t know much of anything.  Really I’m just a dork with a 12-year-old’s sense of humor who guessed enough questions right on enough tests and showed up to work enough times to pass just under the radar.  Am I even sure I’m not still in high school?

This is why I hate the sophisticated patient.  He’ll only unravel this web of lies quicker than the others.  Then I’ll have to get a job faxing things.  And I still have loans, people.

This is called “impostor syndrome.”  I thought I was the only one who had it.  Nah, turns out.  Some of the smartest doctors I know complain about it on Facebook.

If it says it on Facebook, it must be true.  There are a lot of impostors out there.