By Brad Schleenbaker, MD
I look young. I have noticed this intermittently throughout my adult life but I never really invested a lot of thought in it. Then I started my 3rd year of medical school. Really it doesn’t bother me most of the time when people wonder about my age. It’s usually a patient and if I am going to ask them a lot of rather prying questions I figure they ought to be able to hurl a few back at me. Total strangers are a bit of a different story and in short, passing conversations I usually try to side-step the fact that I’m a doctor. Rehashing my academic career since high school for an incredulous, but well meaning, stranger sometimes gets tiresome.
Part of avoiding the disclosure of my career also has to do with me being a resident and therefore having a fragile, resident ego that sways somewhere between feeling like I might actually know what’s going on and wondering if I should have been held back a year before they gave me my diploma, usually on an hour to hour basis. Because of this I usually try to, in as few words as possible, relate that I am a resident physician so as not to overstate my capabilities. If someone knows the medical system they are on board instantly but, for everyone else, it just results in a lot more explaining about how even though I look young I am actually a doctor and I haven’t finished all my training yet but I am actually a doctor. Things are changing though. I’m registered for my boards, I’ve signed a contract, and I can count the number of months left in residency on one hand.
Just last week I was on a chairlift at a local ski resort. Three middle aged gentleman sitting to my right were discussing a friend’s hip pain and how he was managing during their week long ski vacation. I gathered that he had one hip with osteoarthritis that was abnormal and mildly debilitating for someone of his age and activity level. He was planning on having the hip replaced but the surgery had not yet happened so he was managing as best he could. They recounted his medication usage and I heard max doses of naproxen, ibuprofen, and acetaminophen. Not wanting to give unsolicited advice I decided to stay quiet. However, their conversation continued with an attempt to remember what the safe dose of each medication was and concluded with the idea that they would recommend to their friend to stop taking ibuprofen and acetaminophen together because that would be bad.
I thought that a few words might be appropriate at this point in the lift ride so I turned and mentioned that naproxen and ibuprofen were in the same medication class and it would probably be better if the absent friend dropped one of those medications instead for the sake of his stomach lining.
“Are you, uhh… a pharmacy major?” queried the man from the middle of the group.
I considered just saying yes. I opened my mouth to repeat a phrase about me being a resident and paused for a half-second. “I’m a doctor,” I stated without qualification. Eyebrows were raised. Maybe it was the crowd but no questions followed about how long I’d been in school or how old I was.
I look young; that’s just how it is. It’s the rare interaction where a patient wonders if my age is affecting their medical care; usually people accept that I’m doing what’s right for them. My countertransference has resulted in a lot of wasted energy and extra stress with really no benefit. Perhaps trusting that people will trust me (even with the infrequent startled look) will help my communication with patients. It seemed to work on a Snowbird chairlift. Although, come to think of it, maybe no one noticed I look young because everything but my mouth and nose was covered by ski gear. Oh well.
Brad Schleenbaker, MD is a third year resident in the Family Medicine Program at the University of Utah School of Medicine.