Launchpad: You Know More Than You Think

The start of summer also means the start of rotating internships. I still remember the anxiety and realization that I was going to be responsible for making the real decisions, enduring endless quizzes and questions, and experiencing the dreaded overnight shifts. 

A few months into my internship, I had an unsupervised overnight shift. A shih tzu named Maxine arrived at the emergency service with a proptosed globe. I had completed only 2 weeks of emergency medicine and 2 weeks of ophthalmology during veterinary school. My experience with proptosis consisted of seeing a single case that had ultimately been referred elsewhere due to client financial concerns. My internship was in the early 2000’s before online videos and instant access to procedural demonstrations. The only resource I had was an ophthalmology textbook and the team around me. One of the technicians on shift that night had previously worked in an ophthalmology practice. During the globe replacement, he held the textbook open so I could reference it as I worked, and he encouraged me throughout the procedure, providing reassurance that everything would be fine. The procedure took longer than I would have liked. I second-guessed myself repeatedly, but I was able to get the globe back into position, with a tarsorrhaphy in place. What I remember most is not the procedure itself but the feeling of realizing that no one else was coming, and I was the doctor in charge.

The dog recovered, and even more remarkably, the eye remained visual. Years later, I still think about that case whenever I work with interns and new graduates. The lesson wasn't that I performed a proptosis repair. The lesson was that veterinary school, internships, and mentorship provide a stronger foundation than we often give ourselves credit for.

As interns and new graduates, we often assume experienced clinicians have an answer for everything. The reality is that many of the defining moments in our careers occur when we face a problem we have not solved independently before. In those moments, success is rarely about knowing everything. It is about staying calm, relying on your training, using available resources, and asking your team for help. 

At some point, every clinician encounters a case that feels beyond their comfort zone. When that moment arrives, remember that you may not have every answer, and that is okay. Sometimes being a doctor means opening the book, leaning on your team, and taking the next step anyway.