Caught up

* I rarely blog about my career, but I’ll make an exception this time.

From enthusiastic freshmen who are excited to enter the hospital, we are reduced to juniors who are simply struggling to survive. Our bright eyes that scream curiosity are now laden with panda-like blackness, without the cuteness.

We loiter around the campus, with our stethoscopes around our necks and ginormous notes in our hands. We sport heavy backpacks that perhaps contain our lives- laptops, tablets, books, notes, and even food for day-long lectures. 

We sit in lectures, but less than 50 percent truly listen. Some have rather nocturnal cycles, while some are cramming medical reports to be passed hours or minutes later. Medical students like us struggle to survive, struggle to make our reports on time, struggle to fit facts in our heads, struggle to pass exams, and struggle to find time to sleep.

We have been seeing patients for the past two years, diagnosing them, talking with them, and thanking them. And yet, we have been so absorbed with the technicalities of our lives where the next exam judges our survival. This tiring process has somehow diluted why we’re here and why are we answering these exams in the first place.

The essence of medicine is not in the books, or topping exams. It’s in the special relationships that we form with people. We have been looking at words for so long that we have failed to take a really good look at our patients’ faces.

My recent and unusual case presentation forced me to stop seeing words and concentrate on a patient. It was only then, for the very first time, that I felt the surreal essence of this profession. 

We study not for the sake of studying. We study not to pass, nor to top. We study to heal, not our minds or our insecurities, but the people in front of us. 

We are so caught up in the moment of academe.

We must get caught by the moment of medicine. 

*I sincerely hope that if med students get to read this, they’ll smile with their panda eyes. Let’s have our moments with our classmates, professors, and patients. Time flies so fast, that even the mundane classroom life will be missed and cherished. May I become an awesome MD like my tumblr idol, Dr. Cranquis! :)

“Invest in building your network. It will pay dividends in the future.”

—A specialist’s advice on building relationships with other doctors, community resources and services in a future practice.

TheNotQuiteDoctor Presents: What to expect when you're expecting (to start med school)

Hi! First of all, I really enjoy reading your blog! Second, I’m a senior in undergrad who has been accepted to med school (YAY!!!), but is looking at the next year of my life with a healthy combination of fear and excitement. Not sure if you have done a post like this already, but could you offer some wisdom on surviving and thriving as an M1?

First off, congrats on getting into medical school.  That is an amazing accomplishment.  My first bit of advice is to really reflect on that and let it sink in.  You got in!

Now I have a disclaimer.  I am still in my first year of med school (three weeks from being done) so I may not be an authority.  But I feel like I have enough experience to offer some advice.  So take this for what ever you think it is worth.  Here are some tips (in no particular order) for the coming year:

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How to date a Med student:

1. Don’t expect to see them. Ever.

2. Accept the fact they will have many affairs. With their books.

3. Learn to hide your “ew, gross” reactions when they tell you all the stuff you never wanted to know about your bodily functions.

4. Support them when they come home after each test, upset because they failed—and gently remind them after they get their well above passing grade how unnecessary the “I’m going to fail out of medical school and never become an MD” dramatics are.

5. Each week they will have a new illness. Some will be extremely rare, others will be more mundane. Doesn’t matter. They will be certain they have it (no second opinions necessary.) Med school can, and will, turn even the sanest into a hypochondriac. Date them for long enough, and you’ll become one too.

6. There will be weeks you’ll forget you even have a boyfriend—friends will ask how he is and you’ll say, “What? Who? Oh….right. He’s well…I think.”

7. They’ll make you hyper-aware that germs are everywhere and on everything. Even though you used to walk into your home with your shoes on, and sit on your bed in the same clothes you just wore while riding the subway, or sat on a public bench in, you’ll become far too disgusted to ever do it again. Believe me, it’s going to get bad…you’ll watch yourself transform into the anal retentive person you swore you’d never become. And when you witness others perform these same acts that, before you began dating your med student, you spent your entire life doing too, you’ll wince and wonder, “Ew! How can they do that? Don’t they know how many germs and bacteria they’re spreading??!”

8. Romantic date = Chinese take-out in front of the TV on their 10 minute study break.

9. A vacation together consists of a trip down the street to Walgreens for new highlighters and printer paper.

10. Their study habits will make you feel like a complete slacker. For them, hitting the books 8-to-10 hours a day is not uncommon, nor difficult. You’ll wonder how you ever managed to pass school on your meager one hour of studying per night.

11. They’re expected to know everything. Everything! The name of the 8 billion-lettered, German sounding cell that lives in the depths of your inner ear, the technical term for the “no one’s ever heard of this disease” disease that exists only on one foot of the Southern tip of the African continent. But ask them if your knee is swollen, or what you should do to tame your mucous-filled cough, or why the heck your head feels like someone’s been drilling through it for oil for two weeks straight, and they won’t have a clue.

12. “My brain’s filled with so much information, I can’t be expected to remember THAT!” will be the standard excuse for forgetting anniversaries, birthdays, and, if you get this far, probably the birth of your first-born.

13. You’ll need friends with unending patience who pretend never to get sick of listening to your endless venting and complaints. Or, you’ll need to pay a therapist who will pretend never to get sick of listening to your endless venting and complaints.

The Burning Flush of Confrontation

I stood there and did my best to explain what we felt was going on, our impression of the possible causes, and our investigations around them, some of which simply could not be done tonight.

The family was not satisfied. “We want answers. Now.” From there came the questions. “Why must it happen later? Why is this test being done? Why will you not take our complaints seriously?”

I reassured everyone that we were checking every avenue, that there was a method and reason behind the tests and explained as plainly and thoroughly as I could. More importantly, I tried to address their concerns up front and with honesty.

Nothing could appease my audience. I could feel the growing dissatisfaction in their tone, the tension that my presence brought to an obviously well meaning and concerned family.

However, standing there, the focus of every pair of eyes in the room, I began to feel the churning of my stomach, the pounding nudge in my chest, and the burning flush of my face. I had become an enemy in the room, an obstacle between the vocal family who wished to be heard and heard by none other but the doctor himself. It was time I excused myself.

I returned quickly to my attending and explained the situation: I had attempted my best to alleviate their anxiety and answer their questions but I had failed. I needed help.

When he arrived, even then the discussion presented challenges. It took a lot of work to come to an agreement and understanding.

The communication channel is open both ways. The solution to defusing a situation like this is always to make people feel that they have been acknowledged, that their concerns have been understood, that they are not an afterthought in this already complicated system of care. Even with that in mind, the discussion can be challenging. It really takes a lot of patience, perseverance, and thick skin to build up the rapport needed in difficult situations.

Perhaps with time and experience, I can find a way to finally manage this myself. For now: please do not shoot the messenger.

Were you ever involved in a confrontation? How did you deal with it?

“Agree with above medical student's assessment. ”

The satisfying addendum by attendings to a well written assessment and plan.

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