When I was a student and intern, I wish I had the advice of Dr. John Preston in his two blog posts, Depression: Often Obvious, Sometimes Hidden, and Stress and Anxiety, particularly his comments about fatigue.

Once, as an intern (which for me was the most difficult year in my medical education), I was interviewing an elderly woman who was admitted about 2AM.  She was very slow to respond to questions and I actually fell asleep during the interview.  Perhaps it wasn’t that bad, because when I awoke, the patient was also asleep. But it shouldn’t have happened.

When I first began my internship, the chief resident told us that if there was any time during the year that we were just too overwhelmed and couldn’t see an admission that we should call him to arrange for someone else to handle it.  This happened to me once during the year.  It was about 3 or 4 AM and a new patient was admitted; I was just not functioning and needed a brief period of rest.  I called the chief resident, and he responded with a witch hunt against my incompetence.  Now, I realize that he must have had his own set of problems and didn’t want to be disturbed, but I continue to have bad memories of the time.

As a medical student, I remember overhearing an attending commenting to other students about what an idiot I was.  (I also remember him as a physician who was not especially kind to his patients either.)

Perhaps it was my sensitivity to the problems that even excellent students face in the course of medical education that influenced my decision to start MedMaster in 1979.  There is so much to know and so little time to learn it.  There is a battle between trying to study enough and also having enough sleep and personal time.  I have received many letters through the years from both students and instructors about the value of the small, clinically relevant book that provides understanding and rapid learning.  I hope these books continue to be of value.