Somewhere between the hours of four and five AM, I realized I wasn’t going to get any more sleep for the rest of the morning. As the baby stared up at me and smiled broadly, unsympathetic to my exhaustion, I was reminded of the last time I felt that sense of necessary learned helplessness. It was when I was first out of medical school and just trying to find my footing. In a lot of ways, being a new dad is just like being a brand new doctor.
1. You learn to distrust the quiet.
Whether it’s your child sleeping soundly for an extra hour, or your pager not going off for the same period of time, you can’t seem to relax. You become convinced something has gone wrong. You put a hand on the baby’s chest to make sure they are breathing and check the battery in your pager. When finally you begin to allow yourself the fantasy that maybe you have stumbled upon some unexpected downtime, the sirens – human and otherwise – start wailing.
2. You never really feel comfortable having so much responsibility.
On most days, you still feel like a kid, and even though you can remember growing up and graduating from various levels of education, it still doesn’t feel quite right that you’re in charge of other people’s wellbeing. You recall that you’ve always had trouble keeping plants and fish alive for long periods of time, but now you have a baby to raise. Similarly, as a new doctor, you are tasked with covering scores of patients overnight with little supervision. Both scenarios occur in utter sleep deprivation. Every night though, you look around and realize that together you all managed to make it to the end of another day.
3. You learn that empathic listening almost always comes first.
Whether it’s a patient in acute distress or a baby screaming at the top of his lungs, the solution usually begins by engaging in the exercise of putting yourself in their shoes. Patients will almost always tell you what’s wrong with them if you take the time to truly listen, and babies will do the same if you pay close attention to signals around their feeds, sleep, and diapers.
4. At a certain point, you give up caring about your appearance
You start out with the best of intentions to pursue showers every day culminating in a full change of stylish clothes. Somewhere around week two or three of a busy, sleep deprived stretch, you realize your five-o-clock shadow is turning one hundred and there’s so much grease in your hair that it leaves a mark on the pillowcase that hasn’t been laundered in weeks. You’re spending your time and energy on more important things, you rationalize to yourself. But really when you finally do have any time to yourself …
5. You begin to engage in revenge bedtime procrastination
“Revenge bedtime procrastination” is a phrase that became popularized during the pandemic as so many people were stuck working at home in cramped quarters. Many started staying up late into the night just so they could have some time all to themselves. They knew they would pay for it in the morning, but it just felt necessary to have that brief respite just for themselves. Those of us who have been through a medical residency or had a small baby in the home have known about this phenomenon for as long as time. Why catch up on sleep when you can finally watch that Friends rerun that you’ve seen twelve times before?
6. You become eerily superstitious
The baby seemed to sleep better after you read him that book about the farm animals, didn’t he? You should probably do that every night. A few nights later, when your luck runs out, you think to yourself I must have read it wrong. Similarly, on the medical wards, when things are going well with your patients you will do anything to keep the clouds overhead light and fluffy. When eventually storm clouds develop in the form of too many admissions, complex cases, missing med lists, you’re likely to blame it on the unlucky scrubs you were wearing.
7. Your missteps never leave you, but your successes make it all worthwhile
When you have a near miss, with either your baby or your patients, you never forget it. Maybe you looked away for just a single moment and something catastrophic was just barely averted. If everyone walks away unscathed, happy and healthy, you breathe a sigh of relief and hope to learn from any mistakes you’ve made. You balance those moments, though, against the times when you’re there for the magic – a baby’s first steps or catching him say dada for the first time, or in medicine when you do something just in the nick of time to save a patient from suffering. Those are the bits of manna from heaven and just about the most fantastical thing in the world. In both scenarios, the successes are what you savor, and what you’ll miss the most in the years ahead.
Adam Stern, MD is an assistant professor of psychiatry at Harvard Medical School and the author of the upcoming memoir Committed: Dispatches from a Psychiatrist in Training, due out on July 13, 2021.