Thursday, September 29, 2011

Trying To Spread My Overabundance of Optimism

Well, we're in the thick of it now.

Two molecular biology exams, a histology exam, and we just finished our fourth exam - the big one - the first block of Anatomy. The entire musculoskeletal anatomy from the neck down. Origins and insertions of the muscles, nerve innervations, blood supply, ligaments and tendons, lymph node locations, and more.

That's right. All of it. Whoo boy. Allow me to point out now that medical students may relate to this post a lot more, but I hope that anyone who reads it enjoys it for what it's worth.

But we somehow made it through, and had one of the most relaxing weekends we all have ever had. Hence, I am writing a blog entry. I actually started this entry about a week and three days ago, after the third exam, but due to the immense amount of studying I had to do for the next exam (and the fact that the Buffalo Bar Crawl was that night) I ended up putting it off. But here I am again, and I can remember the feelings I had that night as if it was yesterday.

I had walked out of that biochem exam at around 12:30ish, mentally exhausted but unable to rest because I had to go straight to my preceptor's office to shadow the doctor there and try to practice what few clinical skills I had. I had had a long week with two exams, as had the rest of my 143 classmates, and I really just wanted to go home and sleep, with a dim idea of attending the Bar Crawl and a despair stemming from the thought that I would need to wake up early the next morning to start studying for Anatomy. I stood there for a few minutes with some classmates who had also left the exam, discussing answers and wincing every time I realized I had gotten one wrong, and then left because I remembered that I had to stop at the bookstore to pick up a lanyard on which to put my medical school ID card. I remember wondering why I had chosen to put myself through this...why all 144 of us, the ones that did incredible on the exam and the ones that did less than incredible, the ones who smoked the anatomy exam like a holiday ham and the ones who got spanked with it, the ones who rock every encounter with a standardized patient and the ones who are still uncomfortable...why are we doing this to ourselves? Why the torture and the mental exhaustion, and the 19-hour days where you come home at 2 AM reeking of formaldehyde and Taco Bell? (Note: That second part might be just me.)

This question was answered by two things that afternoon. The first was as I reached my car, already dressed in a dress shirt, pants, shoes, and tie. I headed to the bookstore and picked up a lanyard, clipped my medical school ID card to it, and slipped it over my head...and then I went to my car and put on my white coat.
Now, I am aware that I am still just a medical student ("just?"), not an actual doctor. I am aware that I have only scratched the surface of treating patients. And I am aware that I am a little conceited. But as second-year med student (and my best friend) Ketan put it, "The white coat is designed to make people look good." And I must say...putting on that coat felt pretty good.

Immediately my day picked up a bit, but I still felt fried. How was I going to be enthusiastic for my preceptor, and for his patients? turns out that I would have a little help. Arriving at Dr. Stephan's office, I was immediately led back to the office kitchen (where the staff had been given lunch by a pharmaceutical representative) and introduced to the tall and imposing yet soft-spoken doctor who I will follow this semester. From the very first patient he took me beyond what was supposed to be an observational role - he had me assist in minor procedures he conducted, guided me through parts of the physical exam to observe abnormalities he found, and encouraged me to ask any questions of him or the patients.

Now, that's just a great preceptor, who is enthusiastic about his students - I had hoped for as much (and I know not all of them are like that). But the thing that really got to me was something that I had been told about but had never actually expected: the patients were really enthusiastic about me being there. Some of them were in too much pain or discomfort to care, but they were still happy to answer my questions, let me see what was happening in or on their bodies, and do anything they could to help train and advise a future doctor. For much of the morning I had been in a dense fog of biochemical pathways, histological sections, and anatomical figures. Still, with the very first patient I saw, the fog lifted, and I truly realized for the first time the incredible responsibility I have towards these patients and their bodies and minds, and how much they trust me. For me, that was not intimidating...rather, that is what makes all of this worthwhile.

I realize that I had a great day and that there will be bad ones (to those that have already had those...I'm so sorry). There will be difficult patients and coworkers and insurance crises and all of that. But does the good outweigh the bad? I'm betting it does. Maybe I'm too much of an optimist, but I really believe in that.

The experience puts things in perspective. So even though I spent the next week studying anatomy until I was blue in the face (which is really hard for a brown man), I kept my head up. And over the last week, I took pleasure in the fact that I have had time to chill out with my friends. I have enjoyed the little things in life, like a classmate's homemade carrot cake or apple pie, or the sound of a new jazz album. But all the while I have kept these feelings in mind.

So to the patients I met that day: Thank you.

To my fellow medical students, dental students, and any students who are wondering why they are doing what they're doing: most of the patients/constituents/customers/clients really do trust you, which is an amazing feeling, and I hope we all take it as seriously and with as much gratitude in twenty years as we do now.

And to the med students: you look damn fine in your white coat.