Today, while working with a new attending (I'll call him the Zen Master) in general medicine clinic I had more autonomy than ever before. With three of the patients I saw, I came back to the Zen Master's room, presented my findings, told him what I wanted to do, and he said "ok" signed the note, wrote the orders, and told me to send the patient on their way. Granted, there are uncomplicated complaints, but it still is fun to reach that stage of proficiency and trust.
The Zen Master is also a great teacher. When a patient was late, we sat down and discussed some articles from the New England Journal, he quizzed me on algorithms for the work-up of various complaints, and he expressed his own philosophy of medicine. I think the letters "M.D." after a person's name predispose them to philosophizing and solving the world's problems on the back of an envelope. Although I'm probably already there without the letters. Maybe that kind of person just goes into medicine.
Dr. Woodley also had some great comments when I ran into him today. He said "People read these [scientific] papers like they're gospel. They're so far from gospel I can't even begin to tell you." And then later he pronounced: "Medicine is not for the brilliant. In fact, anytime you find a brilliant doctor, make sure his nurse practioner is real compulsive and attentive to detail. Brilliant people are liable to be absent minded and hurt people." Priceless.