A Candid Look Into the Life of a Pediatric Resident

job interview Dr. Meghan MacLean Weir is not afraid to admit her faults. In fact, in her debut book, 'Between Expectations: Lessons From A Pediatric Residency,' she boldly goes where other physicians fear to tread -- into a candid description of her struggles as a pediatric resident at Children's Hospital Boston and Boston Medical Center.

We take for granted that our doctors are confident, highly-skilled and well-trained. In this rare memoir, Weir opens up about her personal trials as a struggling pediatric resident who felt let down, overwhelmed and frustrated that medical school had not taught her everything she needed to know to help guide others through the health care system.

Writing through her own experiences

Even with all the unforgiving aspects of her duties and rounds as a resident faced with death, illness and children, Weir uses the writing of her book as a therapeutic exercise to not only help process her own daily experiences and emotions, but also as a way to share what she learned with others and to tell the story of some very brave and interesting families.

There are a lot of other books that give glimpses into what it's like to be in medicine, but none like this. "In choosing the families that I wrote about, I selected children that I felt had been through special moments and experiences," Weir says. "Moments I didn't want to lose because of rounds or paperwork. As you are going through it, you don't always realize the power of it."

Lessons learned

Weir learned lessons day in and day out in her profession, but the three most valued ones were: to know when to ask for help, to learn to adjust our expectations and to acknowledge that there are things that we can do for families in a hospital setting to help them mourn the loss of a child.

Ask for help

"It [asking for help] is not a failure. Sometimes asking for help is the best thing we can do," says Weir. Over and over, the resident was reminded that she does not have superhuman powers and that just because she is a doctor, she cannot be expected to know everything all the time; she did not feel "prepared to do the job that was expected of us when we were done."* Clearly, being a doctor is a learning curve and a constant process.

Adjust your expectations

Not every medical school graduate fits into the same perfect doctor mold when they begin their residency, and that is OK. It's about finding what works best for you as a doctor and as a person, so that you can have success in both areas. Meghan came about this realization the hard way -- by living through it. As a three-year resident, she had barely started her internship before she felt unhappy. Weir knew that residency was a wonderful opportunity to learn, but she quickly felt the effects of being spread too thin and says that like many other residents, she "rarely had time to appreciate this privilege."*

To remedy this situation and her feelings of "not being able to make it," Weir requested a modified schedule and was granted the right to work 12 weeks on and four weeks off, ultimately finding that much desired work-life balance.

Appreciate what you have

Understanding death and what families with terminally ill children go through was not something Meghan fully comprehended until she was working in the hospital setting. To paint a picture for the reader about just how hard it is to not know everything as a doctor, Weirtalks about how she treated babies and sick children all the time, but "knew absolutely nothing about babies, before I got to take care of my own."*

The valuable lesson these featured families have to offer is one about being informed and more knowledgeable. "I hope that the life and death situations that these families are in is compelling and I hope that readers feel some connection to these families in some way so that they can appreciate their own lives a little more."

Drawbacks to being a doctor

"I sometimes wish I could go to an office job and check off things from my to-do list, but when you are a doctor you never know how each day will go," says Weir. For many people, not having a regimented schedule or sense of absolute knowledge about your job is a major turnoff and too scary to contemplate, but Weir believes that its part of what helps drive her to go back every day -- because for her, having just one thing in this world to call her own (being a mother, being a doctor, being married, etc.) is just not sufficient. "I get to talk to families all day and work with babies and I think that is pretty cool too."

Next, Weir is working on a collection of short fiction stories with recurring characters from a hospital setting, and blogging about parenting and medicine on her personal blog, advancedmaneuvers.blogspot.com.

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*Quotes followed by an asterisk were taken directly from Dr. Weir's book

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Rather a mundane piece, boring in fact.
One important point: you will often fail to ask for help because you don't know what you don't know.
Sometimes in medicine you'll be like the guy who "not only don' know nothin' - he don' even suspec' nothin' "

June 24 2012 at 3:37 AM Report abuse rate up rate down Reply

As a Registered Nurse for 43 years and still practicing I think you will never stop learning and you will always have to ask for help at times. Practice as a team always and life will be good. And one more thing, always be open to teach others along the way what you have learned.

April 04 2011 at 7:41 PM Report abuse +7 rate up rate down Reply

I wish the best of luck to your young patients, sounds like they need it.
Let this be a lesson to all you parents out there---pick an older doctor for your baby.

April 04 2011 at 7:36 PM Report abuse -6 rate up rate down Reply
1 reply to willisn's comment

Thank you old doctor. And when a newer, more advanced procedure goes unused on one of your critical patients thanks in part to your plaque coated synapses, you'll say what? "Oh well, they sould have gotten a younger doctor"?
I truth, all hospital settings offer a team approach to both your care and your baby's. That team includes professionals in all age groups. To imply otherwise is disingenouous of willisn at best. At worst it is a self serving lie to drag business into an old and failing OB-GYN practice. Ladies and gentlemen, place your bets. Carefully.

April 04 2011 at 8:14 PM Report abuse rate up rate down Reply

Thank you Dr. Weir, I do not know you personally but I appreciate all the effort you have put forth to become and practice as a physician. I could not imagine the joy and grief that comes with treating patients. It takes a very special person to decide to be a doctor and follow through with it. If writing helps you cope with all the emotions that you experience in being a doctor, then by all means write away. You are only human, perhaps more educated than most, but that doesn't increase your chances at super human powers. Everyone makes mistakes, however doctors where medicine and patients are concerned are expected to be perfect. I could not personally handle that type of pressure, so I appreciate all the doctors that can. Admitting you need help, is a character strength in my opinion. I would much rather a doctor say to me, I am unsure of this particular problem so let's consult a specialist or someone else in that area, than to be arrogant and choose a wrong/harmful solution.

April 04 2011 at 7:35 PM Report abuse +5 rate up rate down Reply

Other than the rude comments, which aren't worth a response, there is one question raised by several people that might warrant a response. Why would a doctor write a book? Be a doctor or be a writer. (That reminds me of the cartoon that should Dickens with his publisher who said, "Mr Dickens you have to make up your mind. It can't be both the best of times and the worst of times.") People in many professions have found that writing about their experiences is first of all a way to understand them and move on and, sometimes, second of all a way to share something of value with others. Some of those books, like Jonathan Kozol's "Death at an Early Age" help change the world and we would have been poorer if Kozol had chosen to be only a teacher and not a writer as well. Dr. Weir has chosen to be both a pediatrician and a writer. She is working in one of the hospitals where she did her residency, which would seem to indicate that the doctors there see her as a valued colleague.

April 04 2011 at 7:28 PM Report abuse +3 rate up rate down Reply

The sad truth is doctors in training have to spend many, many hours in the hospital to be exposed to and learn how to manage the huge amount of pathology out there before they are released into the world and have direct responsibility for keeping these patients alive. And when you get to that real world, especially if you are a specialist who has no choice but to take hospital night and weekend call, you can't say "I've worked my 18 hours, I get to go home now." You can work all day, all night, and all the next day too, because there is nobody else to take up the slack. I have to agree with a previous comment that if she spent more time studying, and less time expressing her angst on paper, she would be a better physician.

April 04 2011 at 7:22 PM Report abuse -6 rate up rate down Reply

What I do not get is how come you are writing this stuff as a resident? Every medical student pass through this phase but not resident... perhaps, you started the book as a medical student and just completed it... but if these were facts you learned as a resident, what did you learn as a medical student?
I really wish you luck and you could further in medical areas with less "traumatic" experience and office like schedule if it is not too late... I am sure you know that...
Well, good luck pal

April 04 2011 at 7:13 PM Report abuse -3 rate up rate down Reply

I have worked in a pediatric ER for 14 years. We watch all resident DR's like hawks waiting for thair prey to screw up. They typically don't get the chance. The people working around them... RN, techs, attending physicians and so on don't let them....rest easy it's part of our job that is deligated to us by our attending physicians....the one with the years behind there belts.

April 04 2011 at 6:55 PM Report abuse -2 rate up rate down Reply
1 reply to robereha's comment

You have worked in pediatric ER for 14 years yet can't spell delegated?

April 04 2011 at 7:23 PM Report abuse -4 rate up rate down Reply
1 reply to mail4van's comment

hey mail...she can't spell thair either , but you R N ASS

April 05 2011 at 6:07 AM Report abuse rate up rate down

I don't agree with your high handed critique, Its better to ask for help rather than have the white coat attitude covering up lack of practical experience or expertise on how to perform a procedure but going ahead and making a fatal error .

April 04 2011 at 6:41 PM Report abuse +5 rate up rate down Reply
1 reply to maur's comment

I say bravo for Dr Weir .

April 04 2011 at 7:27 PM Report abuse +5 rate up rate down Reply

It never ceases to amaze me how niave doctors are. The lessons she learned apply to every single person and every single field of endeavor. Knowing when to ask for help is basic for any profession and she should have learned that in college, I know that I did. Her comments about wishing she had a nine to five job where she could "check off things to do" show that she has as little knowledge of how the "real works" as she does about working as a medical professional. I didn't realize that the "God syndrome" took effect until you had actually practiced medicine for a while.

April 04 2011 at 6:39 PM Report abuse -6 rate up rate down Reply

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