WTF is Wisdom?

As I get older and more experienced at my job, the less I think I know. It almost becomes overwhelming how much I realize I don’t know. Or can’t remember anymore. In my younger days I felt so confident that I had the right answers. I felt comfortable, even complacent in my level of knowledge.

Does it leak out with age? Am I actually getting dumber? Or is this just a memory issue? I don’t feel I’ve ever had a great memory, but definitely adequate. Now? Sievelike. Stupid stuff like usual doses of common meds or details of basic physiology are just gone, buried somewhere deep in the recesses of my mind. I know they were in there in the past, but I struggle to access them now!

Its an uncomfortable feeling, not having that knowledge at the ready. I’m embarrassed how often the fear of being asked about something and not having the answer keeps me up at night. Sometimes I study stuff and make cheat sheets just in case I get asked about stuff. Am I sick or is this just how brains age?

So my brain on facts and details absolutely sucks. But my big picture thinking is maybe even better. I think this is where all of the experience goes – toward enabling a better grasp of how things interact and move together, even if the particulars are a little hazy. For example: When I’m called requesting sedative orders for a restless patient I know to ask more questions about why the person is anxious before jumping to medication. I also will include other team members (like chaplain, social worker) if they are the best “tools” for the job. I also might suggest changes to the environment if these are provoking anxiety and look at if the family is well-meaning but contributing to the problem (not uncommon). I’d also assess the person’s feelings about sedation in general and consider fall risk before trying a sedative. Younger me would have probably just ordered the drug and called it good, not thinking much about these other angles. So, my older brain may be slower and not have as many details accessible in the “top drawer” anymore, but I think I probably make better, well-considered overall decisions. I guess this is wisdom? I’ll take some comfort in that.