I'll share a clinical anecdote where I (rightfully) felt like an absolute *****. This is a story I share with the now M3s when we talk about feelings of incompetence, cluelessness, etc. etc. which seems to be very common among third years, especially in this time of the year.
On OB/GYN, we spend a couple of weeks on the gyn service, which is essentially a purely surgical experience: come in, get the schedule, read on the patients, and go to cases. One case was a robotic vaginal hysterectomy to correct pelvic organ prolapse, during which my job was to be the uterine manipulator. In basic terms, this essentially entailed wielding what was a steel dildo and applying pressure in various directions to expose the field for the surgeon. Since the procedure was robotic, I sat at the foot of the bed and used the displays to try and get the view she wanted.
The patient was particularly obese - to the point of not even being able to see the vagina, or really anything. At the beginning of the case I had trouble getting all of the tissue out of the way to see where I was actually going with the manipulator, so I did the next best thing I could think of: I followed the Foley, traced it back with my hand, and essentially aimed the manipulator where my hand was.
About 45 minutes into the case, the surgeon says from the console that "things don't look right" and to make sure that there are no obvious problems. She was dissecting down to the uterus and was having trouble identifying the fascial planes she was looking for. She specifically asked me if I was sure I was in the vagina and not the rectum; I double-checked and told her that I was pretty sure that I was. Another 5-10 minutes goes by, she again says that "this just isn't right," and gets up from the console and comes to the table. She double-checks everything with the resident and again asks me if I'm sure I'm in the vagina.
I really dig in to see where I'm at with the manipulator, and to my absolute and sheer horror I see that I'm in the rectum and not in the vagina. Whether I was in the wrong place to begin with or whether it slipped out of the vagina and into the rectum I wasn't sure, but the net result was that the surgeon effectively dissected down the wrong fascial planes for a good half hour of the case. I pull the manipulator out and, after a couple of seconds (during which I'm more or less in complete shock and expecting quite the lashing), I tell her that I was in the rectum and not the vagina. To my complete surprise, she was actually very nice about it. She said something very similar happened with another patient a few months back, but the mistake wasn't caught until much later and the patient had some significant complications as a result. Also to my surprise, she didn't so much as raise her voice at me or otherwise berate me.
Because I had been applying quite a bit of force in there (since she was obese and had a lot of tissue to move around), we had to get a GI doc in to do a quick flex sig and make sure that no major damage to the rectum/bowel had been done. He gets the scope in and, adding to my horror, I see some mild-moderate bruising along the mucosa where the manipulator had been. Fortunately, though, there was no overt bleeding or perforation, and he said that there shouldn't be any problems. We get back in position (triple-checking that the manipulator was actually in the vagina) and the rest of the case goes well.
That was by far my lowest point in medical school. I've never felt so incompetent or idiotic in my life. I mean, knowing the difference between the rectum and the vagina is something that doesn't require medical training to understand. The degree of shame I felt is simply indescribable. Even a year later I still cringe when I think about it.
So, anytime you're having a bad time in school or you otherwise think you're incompetent, remember this story and tell yourself, "at least I didn't **** up that badly."