a day in the life of a medical student in NOLA

At 6:15 my alarm goes off and on comes 90.7, the local New Orleans station, playing soft jazz music. I clamber out of bed to the bathroom where I take my daily health regiment of gummy vitamins, because there is no better reward for waking up than candy in the morning. It is still dark outside as I roll out my yoga mat. I listen to NPR while I do some stretching, a halfhearted attempt to stay up to date about the going ons of the world. After a shower I head to the kitchen to get some iced coffee and a breakfast of yogurt with my homemade granola. My roommate is at the table reading the news while drinking his third of seven cups of coffee. We chat about what things we get to look forward today, what lectures we have, and the weird dreams that seemed to have infected the whole house. Once dressed, I hop on my bike and start the 20 minute commute to school. On the way I get my morning greetings: the sun waves its first rays at me as I head down Freret street. Down on Simon Bolivar Ave., a man tosses a sidelong glance as he struts by in heels and a haltertop. Passing through Central City, the folks sitting on the median and under the freeway sip their freshly opened flasks and hum an ‘aight baby’ as we exchange head nods.

By 8 am I am sitting in class with the minority of students still attending lectures. Most of our classmates are still sleeping and will listen to them online after they have been uploaded. Then it is time for lab. We climb up towards the third floor, the smell of formaldehyde increasing with each step. It is the scent of the month. It refuses to be contained by our lab scrubs and sneaks into our hair, coats our backpacks, and soaks the pages of our notebooks.

My lab group huddles in the corner before our days work. We have turned into a little family. Each day we take on our assigned rolls. Someone reads the instructions, someone dissects, someone teaches the anatomy we are learning, someone goes over the radiographs, and someone shares a joke of the day. I have become the mother of the group because of the few years I hold over them all and my frequent praises of “oh my god! Look what you did! That is amaaaaaazing!!”, just to make sure that everyone feels special. 

Today we do the heart. We open up the thorax and remove the heart from the cadaver’s chest. They say your heart is the size of your drenched fist. In truth, it is slightly larger and hers fits perfectly into the palm of my hand. My other hand meets it with a scalpel. We move through its maze of chambers, removing hardened clots along the way, observing the muscles, and tracing the pathway where her blood once flowed.

Suddenly telling a joke no longer seemed fitting.

I place it back in her chest, carefully, as if to make up for the mutilation I just caused. The rib cage comes back down. Another lab complete, another stab at figuring out what killed her.

Back in clean clothes I walk to bike and feel a few rain drops. It wasn’t supposed to rain today. I check the weather forecast on my phone: 91 sunny skies, 50% humidity. No rain in sight, but you can never trust the skies here. One minute you are praying for rain, the next you are standing under the closest store awning soaked to the core. Thunder rumbles across the river. I heed the warning. The last time I hesitated left me seeking refuge under a bus stop for 30 minutes when rains caught me just minutes from my house.

I bike back under the freeway. The raindrops stop. The short, winding sidewalks under highway 10 feel are a quick passage through another world. It is an interesting place, with an eclectic group of residents and passerbyers. Some are in wrinkled professional wear, some in pajamas, some carrying their homes on their back, and some with just their solitary bottles. It’s members change throughout the day. The men who greeted me this morning now nap against pillars and the late-risers are now alert, starting their day. I am watching a man sweep around milk cartons stacked with his few possessions when something catches my eye. A baby. A baby in a light pink onesie. She is slung on the hip of a woman who puts a pacifier in her mouth with one hand while the other moves in sweeping motions, animating the story she is telling the circle of friends around her.

This underground world is part of my normal commute scenery. But put a baby in there and everything changes.The harsh reality of lives spent under overpasses is unfit for anyone. But to see a child there is all that much more heart wrenching. With a heavy heart I bike on.

As I turn down past the park I begin to hear music. It gets louder as I approach the middle school. It is coming from the parking lot. I catch a view while I breeze past: about 30 kids have their mouths strapped to instruments, blowing that sweet, tangy new orleans brass music. Their feet follow a different rhythm dancing the kids around as they march together in place. The sounds are infectious. They soothe the soul and bring a smile to the heart.

At last I make it home looking forward to some calm studying. Once inside, I hear a woman and man arguing outside by the street. A few moments later I hear the woman yell for help. Its stops me dead in my tracks. She yells again. “Help! Help me! Somebody Help me! He is hurting me!” I rush out the front door to see what is going on. In the next-door neighbor’s driveway a young woman is lying on her back with a middle-aged man sitting on her. He is doing the splits over her, pinning her down with his legs. He looks up at me franticly and tells me to call the police. Another young woman is rushing down her steps towards the commotion. I stare openmouthed, heart stopped, unable to move. He yells again, and I rush inside and grab my phone. As I come back out dialing 911 a heavyset construction worker and a man in a suit approach the couple telling the man to get off her as she continues to yell he is hurting her. The man in splits holds up a letter, “I am the fucking police; I’m her father!” he yells. Meanwhile I am giving the police details about what’s going on, where we are located, and what they are wearing. The young woman switches between yelling at the man that he is hurting her and proclaiming her excitement to be handcuffed. She says has no father but god, and he is coming for her. After NOPD arrives and handcuff the woman, one of the cops begins digging around in the open car and pulls out what appears to be an industrial whipped cream can. The father seems to motion its used for inhaling something while the woman yells she isn’t drunk or on drugs. It is hard to hear what is being said and it is increasingly unclear what exactly is going on and who the crazy one really is.

By this time I realize I am just standing on my porch staring, so I turn back inside, not needing to make a further spectacle of a family’s drama, or a patient’s madness, or whatever confusion is happening. I am sure this is just the first of many psych-drug related cases I will be seeing over the next four years at least. And then it is back to studying, training my pulse to calm, my breath to ease, and my brain to focus.

It is amazing what can happen in an hour; you can go from holding a human heart in your hands, to feeling your own be broken, then warmed, and then stopped in fear. Then, just as quickly, the heart returns to its regular lub-dubbing, resilient as ever, syncing with the steady beat of this city that always plays on.

Pilot Light

Our first medical school exam a few weeks ago was nothing short of demoralizing. I have never had the confidence I walked in with so completely mocked and torn to shreds. And it wasn’t for lack of studying but for studying the wrong way. I was not alone in this either. With most of my classmates, we felt lost with little guidance of how to proceed. The material alone is not what has made school so difficult; rather it has been the overwhelming cluelessness of what to be doing and how to be doing it. Information is being thrown at you faster than you can see it coming. It seems most of my time has been spent shuffling around books, apps, flashcards, online videos, and anatomy coloring books rather than learning the material they contain.

Second years forewarned us of this by giving a new meaning to FOMO, the term that has infected our generation. No longer is it the Fear Of Missing Out on social happenings, but rather missing out on the best study technique; feeling overwhelmed by the sense that everyone else is doing something different and breezing through material, running laps around you when you stumble around trying to grasp just the most basic concepts. The stress of this alone has been enough for me to fantasize of what the old days of medical education were like; when learning was done out of one solitary textbook. That everyone shared. That was chained to a desk in the basement of the library. That you could only read by candlelight.

But days of such blissful zen are long behind us. Now there is an app that gives you a 3D skeleton model you can dress with layers of muscle, nerves, arteries, lymphatics, while zooming in and out, rotating around 360 degrees to see it from every angle. There are mnemonics for every plexus, and then mnemonics to remember the mnemonics. But they all follow the same golden rule: the dirtier, the more likely to remember.

What were those 12 cranial nerves again?

  1. Olfactory
  2. Optic
  3. Oculomotor
  4. Trochlear
  5. Trigeminal
  6. Abducent
  7. Facial
  8. Vestibulocular
  9. Glossopharyngeal
  10. Vagus
  11. Accessory
  12. Hypoglossal

Oh, Oh, Oh, To Touch And Feel Very Good Vag…… you can fill in the rest.

But all these only take you so far. After the exam I went to talk with the head of the anatomy department, seeking guidance on where best to turn for help. I told him that as a “non-traditional” student, I don’t have a strong science background and want to make sure I am setting myself for success with effective study habits early on. He asked what I studied in undergrad. When I replied Humanities and Latin American Studies, he paused, and asked, “so how did you end up here?” Great. While I’ll give him benefit of the doubt that he asked this in genuine curiosity, it was not the response I was hoping for. He repeated the question constantly nagging at the back of my mind, fueling the infamous imposter-syndrome. So I gave him the scripted answer I give everyone and moved alone. The rest of the meeting was uneventfully helpful, and I walked away with some studying approaches.

But I also walked away with a new question that has been on my mind ever since. Why do I feel it necessary to share up front that I don’t “have a science background”? How relevant is this information to the conversation, or do I use it as a protective buffer? Am I trying to preface my comments so that any ignorant slip-ups may be given a free pass, excused with my supposed lack experience? Perhaps, just maybe, if I set expectations low enough, the possibility of success seems actually attainable. 

But really, who am I trying to convince? It is much easier to judge ourselves through other people than to answer our own questions honestly. Questions such as, do I deserve to be here, am I smart enough, am I cut out for the challenges ahead of me?

Selective amnesia in moments of reflection such of these cause us to forget our accomplishments getting to this point. Whether they be the inexplicable obstacles life throws in our way, or in my case, a premed postbacc from hell, when we rise to confront such challenges, we can surprise even ourselves. When we begin weak and vulnerable sometimes we find strengths we didn’t know we had; and if I have done it once, then best bet is I can do it again. Downplaying the successful work I have done serves no one, least of all myself.

Well, in reassessing the mother of all questions: will I survive medical school? One thing is for sure, the person to answer that question sure isn’t my lab director.

So I hit the books. Losing myself and a sense of time as I combed through the diagrams, questions, and lectures. My new best friends became my neon colored pencils, my sharpener, and the wonderful TAs who stay behind to walk me through anatomical structures and quiz me on radiographs, which I pay for with a hearty supply of jokes.

The body is like a large jigsaw puzzle; once the boarders are formed, the other pieces are easier to fit together, and an image starts to appear. If there is one thing I have always loved, it is a good puzzle. Slowly but surely, I am learning this one. Taking my time with each piece, being careful where I place it and how it fits with its surroundings. 

On Friday we had our second exam. While I have yet to get my scores, I can say with confidence and unabashed pride that I finished with a smile on my face, turing to high-five people as they walked out the door. Because sometimes just a little spark of encouragement is all we need to light the fire under our ass.

And here is to keeping that pilot light burning!