As a Radiologist, once a month I work at a small community hospital in the Southern California desert, twenty miles from the western shore of the Salton Sea. Supported in part by date farms and citrus groves, Indio is a rapidly growing city of ninety thousand, not counting the hordes of tourists who migrate yearly to attend Coachella and other music festivals.

Stationed here, I read diagnostic imaging for the small, sometimes frenetic emergency room. I diagnose broken toes, enlarged hearts, inflamed intestines, and bleeding brains. Between diagnostic studies, I perform a smattering of image guided procedures. I do spinal taps, inject joints, biopsy kidneys, and drain pus from various body cavities. My team and I navigate through arteries and veins under x-ray guidance. I open narrowed or occluded vessels with enzymes and balloons, or shut them down with surgical gelfoam and metallic microcoils, depending on the problem at hand.  

I whisk by the office staff, my white coat floating behind me like a polyester cape, as I stride with purpose toward my next patient. Sometimes, the large hem of my coat catches a doorknob or someone’s arm-rest, and I’m yanked back, stopped in my tracks. It’s kind of embarrassing.

Lots of people wear capes of sorts in their daily work, though they may look different from mine. What do you do when you’re rushing around, doing good work, and your cape gets caught?

Acknowledge it? Keep moving? Spend mental energy feeling embarrassed?

You can button your coat to prevent it from happening again.  Or turn and whoosh it overhead like an anime heroine.

I commit small acts of clumsiness daily.

My work relies on dexterity, but I can be caught ripping a sterile glove, or dropping a Kelly clamp on the floor. I second guess myself as I call for a needle or wire, vacillating between two options, confusing my assistants. Sometimes a complication occurs. Outside the procedure suite, I’m cut off and corrected by someone who knows more than me.  My bank account gets overdrawn. I am wrong with my spouse. The daily opportunities to err are endless!

Shame can creep in, when mis-steps happen in our work and lives. We all have an ego, and mine flinches when mistakes occur. But to do a good job in medicine, you have to leave your ego at the door, and learn from every patient.   

The confidence to overcome adverse events, large and small, comes with time and experience. Eventually, small mis-steps don’t easily rock your sense of purpose and self- worth. For some, this confidence comes more easily than for others. Many in medicine are self- critical. To counter-balance this tendency, I am purposely “shameless” about small snafus. One’s early career is a time to reflect, learn, and move forward, but self-criticism can be harmful.

How do you deal when your cape gets caught?