Monday, October 08, 2007

now I know I want to win the war

Some of my East Coast peeps have been telling me it's very un-autumn-like over there, and that sort of amuses me, since finally, for the first time since I started school, the mornings and evenings are that nice, perfect level of chilliness that is associated with fall. I had this thought yesterday, pausing from tearing my hair out, that I would be having a much harder time of it if I lived in some of the other places I could have potentially lived. Weird how you can just feel fall in the air, know that winter will be mild, and how that can provide such a comfort.

I have sussed out more of the things I need to keep me happy. Somewhere along the way the past few weeks, I lost the obsession with getting the grade. Yes, I still obsess like every good med student seems programmed to do. But I had a kind of reset occur the past few weeks, a reminder of what it is all about, from the most unexpected source.

This is going places I probably shouldn't go here, so I won't go into the details, but I put some puzzle pieces together about the cadaver my lab group was assigned to dissect. The information that is given to us is very sparse, and is probably sparse on purpose. However, there was just enough of it to go on an expedition last week to sort it all out.

It was fascinating, because a lab partner and I had a completely different reaction to what we discovered. Her reaction was: how depressing, doctors suck- they try to fix one thing and screw something else up in the process. Mine was: medicine is not an exact science, and you have to make the best decision with the facts you have at your disposal in the moment. For me, there was something fulfilling about it, about figuring out the whys. For my lab partner, it was about the what, which was death. But death is a inevitability. Death, I'm comfortable with. And to some extent, I'm also aware that death is not something that can be prevented in every case.

And some would say the why isn't really the why that I discovered- the why might be about some bigger plan or about fate or about time running out. I'm not opposed to those why's, but to me the body and how the body works is one big why-- and it's gratifying to me that science explains so many of the mysteries. To me, it makes the other mysteries all the more profound and mystifying.

I might be making it sound like I want to be a coroner. That's not the case. It's just that we're still all little muppet babies in class right now- we're not really exposed to situations where we can do a whole lot (and that's probably for the best) for patients yet. But it's quite easy, given that, to get sucked into the classroom mentality of making it all about how well you answer multiple-choice questions. But the last few weeks, I remembered that important detail, that everything I'm learning right now can quite legitimately be applied to thinking about treating a patient. The point is to learn it well enough such that you have it at your disposal in those critical moments when you have to make a difficult decision that will sometimes have a poor outcome.

And now I've gone and made it seem like I consider being a physician some high-and-mighty office, and I really don't. I am maybe the least idealistic student in my class, because I make no excuses for myself-- I'm not going to save the world by becoming a physician. But I can tell I am going to like it, thinking about the complex variables and bringing it all together and having to take responsibility for decisions. It's a thing too easy to forget in the madness of memorizing nerves and signaling pathways.

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