It's hard to believe that the first real week of M3 year is finished. I've already learned an incredible amount, particularly about how to be assertive, and the particular conditions under which I am not good at it. As I was told to anticipate, I feel out of my element most of the time. What I didn't expect, however, was how calm I feel about not knowing exactly what I'm supposed to do most of the time, and how willing I feel to be put in situations where I don't know what to do. It's as though sometime over the weekend of May 7th and 8th a switch flipped in my brain, and I understood the importance of trusting instructors to have a good sense of whether or not I'm ready for something, rather than trying to assess myself. Some examples:

• On my first day, I was terrified to do a well child exam by myself. I still don't know the answers to a lot of the questions that parents ask, but when my preceptor suggested I go do one, I somewhat numbly agreed, and then went and did it. Lessons One and Two: No one expects you to have all the answers, and 6 month olds are pretty forgiving as you bumble through a physical exam. I was ready enough.
• During my first emergency medicine shift the plastic surgery intern asked if I would like to sew a stitch. I have never sewn a stitch on a person before, and was mostly certain that my craftiness would not help much in this arena. Nonetheless, I did it, and did a pretty nice job – turns out it's not really that hard once the experienced person had closed up the muscle layer and lined everything up. Lesson Three: I don't know yet how to distinguish between things I don't know how to do and things I can't be coached through.

In spite of the fact that things seem to be progressing reasonably well, I can also add an unfortunate Lesson Four to those I mentioned above: I am not good a being assertive when I feel lost, confused, and misguided. I am okay when I am only one or two of those things, but all three are not good. I am trying to volunteer to do new things and put myself out there for learning opportunities, but am also working not to beat myself up about feeling a little shy when I can't even figure out who to ask where I should be and when!

At the end of this week, I feel more than a bit like Walt looks in this photo:

I'm starting to get the hang of it though, just in time for a complete change of pace next week…