Breaking out of the Comfort Zone

Yesterday I ran 12km in the HBF Run for a Reason along with 29,000 other people to help raise over $1.2 million for local health-related charities. It’s the third time that I’ve participated in a 12km event, having done the Perth City to Surf twice before, but this time I managed to complete the course in my target time of 90 minutes (a personal best time for me) and was nearly able to run the entire way. My success was at least partly due to the “encouragement” of my 6’2″ tall, super-fit twin brother who would yell “don’t be SOFT, keep RUNNING!”every time my gait slowed below a shuffle. Aahhh … gotta love family! Anyway I found the whole thing pretty tough and was completely shattered afterwards, walking around like a cowboy for the rest of the day because my hips were aching and my feet were covered in blisters. But it also left me with a profound sense of satisfaction that I was able to push myself physically and mentally to achieve my goal and improve on my previous performance. Plus, I could totally justify spending the rest of the day eating guilt-free dim sum, macarons and peanut-butter cups and still feel smug about my healthy lifestyle!

Thanks, bro!

Thanks, bro!

I was reflecting on some of the other great memories of my life and it seems that often the things which are the most physically, emotionally or psychologically challenging are ultimately the most satisfying. I’m not an adrenaline junkie by any stretch of the imagination. I don’t feel the need to throw myself out of aeroplanes or jump off cliffs or run through fire… but I DO like to step out of my comfort zone and push my boundaries sometimes. A few highlights:

  • Going on a four-week school trip to France during high school. I realise this seems like not much of a challenge, I mean, who wouldn’t want to go on a trip to the land of baguettes and croissants? For the fairly introverted 15 year old me, though, the thought of having to live with a strange family, in a strange country, eat strange food (“Penny, tu manges lapin?”) and survive in a second language was pretty damn scary. Now I’m eternally grateful that I was encouraged to go as some of my closest friendships and long-standing in-jokes were formed on that trip, as well as a lifelong love of crepes au nutella, fromage and McFlurries. Délicieux!
  • The Grouse Grind: a gruelling 2.9km hike up 2830 stairs to the top of Grouse Mountain in Vancouver, Canada. Three days later my thighs still hadn’t recovered. Still – all smiles at the top!
All smiles at the top of the Grouse Grind

All smiles at the top of the Grouse Grind

  • Singing a song that I’d written, at the school eisteddfod – the double whammy of singing in public AND putting my original composition out in the world to be judged! But the amazingly positive reaction was incredibly rewarding.
  • White water rafting on the Ottawa River at the peak of the high water in 2009, approaching the enormous grade IV rapid known ominously as The Buseater, in a little 6 person raft with an obnoxious American and a Canadian instructor hell-bent on knocking him down a peg (ie, tossing him in the river). I was absolutely petrified but no choice but to suck it up and go onwards and upwards. Watch the video below to see how it panned out! I’m the one at the back left. Our rafting experience was made even more memorable by the weather – it was sleeting off and on during the day – and because we were soaking wet after our near-drowning incident it was absolutely freezing. I have never felt so cold in my entire life. But still – despite the terror and the extreme discomfort, the whole experience was TOTALLY worth it.

I have noticed certain parallels in my professional life: moments where I’ve had to step out of my comfort zone in order to get the  job done. It starts off small; the first time you give an injection as a medical student, the first time you sign off a drug order as an intern, the first time you manage a chest pain in the emergency department, the first time you have to sedate a violent, agitated patient. The early years of being a junior hospital doctor are full of these moments as you gradually take on more and more responsibility and never quite feel like you have enough experience or knowledge.

In the first few months of GP training it starts again as you  lose the safety blanket of your hospital team and all of a sudden it’s just you and a patient in the room together and you have to make the decisions right there on the spot. Many of us are lucky enough to have had excellent and supportive supervisors just down the corridor or on the end of the phone to hold our hands through the tough times, and then somewhere along the line you look at yourself and realise with surprise that you have become a confident and competent GP! Which is not to say that you know it all (you never will) but you can manage the day to day problems on your own and apply your existing skills to new or challenging situations.

For me, obstetrics training was particularly memorable for providing many a “sphincter defining moment.” Learning to resuscitate neonates, manage massive post-partum haemorrhage, doing a caesarean for the very first time… all pretty scary. A turning point came for me when I was a junior GP obstetrics registrar on duty at the local hospital when a woman came in with a gushing antepartum haemorrhage. It became clear that she was having a pre-eclamptic placental abruption and needed an urgent caesarean. By the time theatre staff and the anaesthetist arrived 25 minutes later I couldn’t confidently identify the foetal heart and was worried that I would be delivering a dead baby. I also had neither supervisor nor assistant for the surgery so knew that I had to step up and take responsibility for trying to save the lives of both mum and baby. As I was anxiously standing, gowned and gloved, knife hovering, just waiting for the GA, the anaesthetist (a great friend and mentor of mine) looked me in the eye and said “Penny, you can do this.” And 2 minutes later after the speediest caesarean I’ve ever done, a very pale and floppy but alive baby was passed over to the paedatrician, and shortly thereafter started to wail – I’ve never heard a more beautiful sound. I went home that day shaking like a leaf but on a HUGE high knowing that I had saved not one but two lives! I hope I don’t have to face that particular scenario too often in the future but I know that if I do, I’ll be able to manage because I’ve done it before.

Next week I am having to face another scary professional hurdle. I’m going up to north to the remote town of Kununurra to work as a DMO (district medical officer) for the first time. In addition to obstetrics and GP duties I’ll be doing some shifts in ED on my own and will have to deal with whatever comes through the door. I’ve spoken before (here and here) about my lack of confidence in my emergency skills and it probably hasn’t helped my anxiety levels by reading Tim Leeuwenburg’s blog on Burr Holes in the Bush or listening to Casey Parker’s podcast on lateral canthotomy … *panic*panic*panic*. Still, it’s time for me to once again take a deep breath, suck it up, and cope with whatever happens. Nowadays, even though I no longer have a supervisor to hold my hand, at least I know that I can turn to my friends and colleagues on social media for advice and support wherever and whenever I need it and that is a wonderful thing.

So wish me luck! And I’d love to hear from you about times when you’ve stepped out of your personal or professional comfort zone. Leave comments below or tweet me @nomadicgp.

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4 thoughts on “Breaking out of the Comfort Zone

  1. You can always ring someone for advice

    And dont; worry, this kinda stuff is actually rare as rocking horse shit. In 15 years I’ve only had to deal with one extradural in the bush, and that was as a locum in a country town in NSW.

    The ‘do-or-die’ stuff is relatively easy – choices are “do nothing and they’ll die” vs “try something and they’ve a chance”

    the HARDER choices are where there is diagnositis uncertainty or clinical equipoise in options. Which path to take?

    Use your colleagues for advice.

    …and if there’s a little voice on your shoulder saying “perhaps I should do X” then listen to that voice

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