Well, it was about time. I knew I wasn't immune, and that eventually, I would succumb, but it's hard to predict when and why and what will trigger it. And yesterday, unpredictably and quite without warning, the moment arrived. Yes, I have officially become a medical student.
You would have thought the hours spent with cadavers, or the days spent buried in books would have had something to do with the transformation. You might have thought it would be the first time I did something useful for a patient. But the fact is, a med student doesn't do very much that is useful for a patient. At best, a med student does not act to a patient's detriment- that's about the most you can hope for, especially as a first-year student.
No, it wasn't that at all, and I am somewhat sheepish to admit what finally signalled that I am, indeed, an undeniable student of medicine. Yesterday, I was working at a free clinic, doing the usual thing that first-years do, bumble around while trying to walk the line between doing something and faking it. As students, after we see a patient, we go get a doctor, present the case to him or her, and he/she promptly throws away most of what we said (rightfully so, because we're mostly morons) and sees the patient again.
So we did this, like we do. But I was scared of this clinic. I had heard this clinic was more no-nonsense than the others and the physicians who volunteered there tend towards being, let's say, gleeful about grilling students. I had also heard that the goal of this clinic is to see as many patients as possible in a day, so I also figured there would be a little less patience for first-year ignorance than in some of the other clinics. All of this wasn't enough to put me off from going-- I think every clinic experience is important in terms of humbling students, especially the ones that do well with all the nitty-gritty book work, that there's this whole other dimension of medicine that we are not even close to incorporating into our thinking. And what's more, you have to learn it in a very different way, and it doesn't have 100% to do with cold, hard facts.
Off we were, doing our thing, stumbling through patient interviews and nervously pacing ourselves through the physical exam. Then we went to get the physician and my stomach dropped. It was the exact doctor we'd all been warned of, the one that has a penchant for drilling anyone around and taking them down a few notches. On top of that, he seemed grumpy on this particular day. I turned to the second-year I was working with and gave him this pleading look, but he ignored me.
We went to see the patient, and the exam began from scratch, for the most part, with the doctor telling us everything we caught and the everything more that we missed. I was surprised. This guy was actually teaching us a considerable amount of practical information while taking good care of a patient. But then, his eyes fixed on me, and I had that feeling that people get when a bear spots them in the woods. Should I run? Should I pretend I'm dead? Don't antagonize. Maybe if I just stand very still, he won't notice I'm here?
The questions started. The first one was easy. The second one was a more obscure question, but I threw a hail mary, and actually answered correctly. The doctor turned to the second year and muttered, "ask most surgical residents and they don't know the answer to that one." I think this is the closest you get to a compliment from this doctor.
Don't get me wrong. First of all, I guessed, so there is no need to conclude that I am in any way extraordinary for answering the question correctly. Secondly, as I pointed out myself to the doctor, I learned some of this stuff this year, so if you ask me the same question in 6 months, there is a very good chance I won't even be able to guess correctly. Third, my knowledge of this obscure fact contributed in absolutely no way to treating the patient any better.
Rationally, I knew all of these things. And thanks to my, ahem, advanced age, I didn't walk out of clinic that day with an inflated ego. But I did learn that I like the game. And when I thought about it, I kind of always have. I inadvertently do it to other people when I'm studying with them- basically pimping classmates into working something out for themselves rather than directly explaining it to them by spoon-feeding. It's not that it was so wonderful that I got the questions right. It's that I liked the process. During the course of the day, there would be plenty of other things I got wrong and had to have explained to me. But I liked it. I like the quizzing, the thinking, the searching the memory banks, the answering, the follow-up, the explanation, the idea that I could be learning something new from now until forever.
I know I sound like a nerd. I know I sound like an idealistic windbag. I know I sound irritating. And undoubtedly, though I've tried to dispel it, I probably sound arrogant too. And if it walks like a duck, and quacks like a duck... yep, it's true. I'm a medical student.