Welcome to Third Year

It would be hard to miss her. She walked into the atrium, towering tall in a bright orange jumpsuit. She was led down the hallway, her handcuffed arms held straight out in front of her, palms parted as though to grasp a bouquet of flowers.

When we saw them later that afternoon, they were uncuffed, poking through flimsy sleeves of the hospital gown she was given. Without her body wrapped in its orange uniform, or the security guard sitting at the foot of her bed, you wouldn’t know she came from the prison. She now matched her neighbors, donning that sad sky blue material, that pitiful excuse for a color. The one decorating most healthcare facilities, the one that is supposed to warm up sterile rooms and hearts alike while failing at both. Continue reading “Welcome to Third Year”

Finding your Dx

Recently, I wrote this email:

Hi Dr. W,

I was a patient of yours in 2006 when I started at Scripps college.

I’ve thought about you many times as the years have passed, how lucky I was to receive such wonderful care. I am proud to say I have never relapsed since, and am strong, healthy and happy. In fact, I am now a medical student at Tulane, hoping to pay it forward. 

Thank you for your work,

Alana 

I’ve heard a lot about the self-pathologizing that happens in medical school. How everyone will start to think they have the various diseases we learn about. With my own family history of hyperchondriasis, I too, have been waiting to find my rare diagnosis. Waiting to learn about the condition that pieces together all the symptoms I didn’t even know I had. Luckily, by now we’ve gone those most of the bodies systems, and my bones, blood, and organs have come out “unremarkable”.

Then we started on the brain.

Continue reading “Finding your Dx”

School assignment

The million do$$ar question:

What do you think your voice and sense of social responsibility is as a physician-in-training?

A first year medical student’s answer:

I would not say that I stumbled into medicine. It requires too much hard work to be an accident. But it was an unanticipated deviation from the original career path I had started down. The latter was a life in the non-profit world, centered around social justice with a focus on women’s international human rights. My move towards medicine was not a break from this work, but rather an opportunity to address it from another direction. I believe that healthcare, as a basic human right, is foundational to any fight for justice. As such, I came to see how the practice of medicine is the use of set tools to effect tangible change.

I love the notion medicine as a practice of the art of healing. It is a precarious balance of holding compassion in one hand and objective decision-making in the other; it is a creativity to read between the lines, hear between the breaths, and feel the silence of emotions between words. Much of the art cannot be taught in a textbook, or a lecture, but from the humility of failing over and over and over again in the hopes that maybe next time you will get it right.

Amidst these lessons, our training places us at a unique intersection of our hippocratic oath, legal mandates, and our own moral codes. Sometimes these align, sometimes they stand in staunch opposition. Sometimes we must suspend our personal beliefs at the door to provide the best care for a patient, but to also not forgetting to to pick them up on our way out.

It is an difficult role for it requires numerous character changes: a patients’ confidant at the bedside, an advisor to a business, an expert at a court hearing, as well as a friend, a lover, a caregiver, a family member, and an ordinary citizen. In choosing this career, one necessarily chooses involvement in issues they have never experienced and is confronted with questions they have never had to answer. Sometimes they are small, like helping a patient figure out transportation options to ensure they make their next appointment, or finding a free clinic for an uninsured patient to get affordable prescription medication. Sometimes they are much larger, like how to respect a family’s religious requirements for burial while also complying with state mandated autopsy orders or organ donations.

As physicians-in-training, we are no longer isolated to the problems and injustices that impact us personally. When we commit ourselves to the care of a patient, we must seek to address their well-being. Our white coats with embroidered names place us in a unique social hierarchy that values our voices. While we cannot take on every struggle nor pick every fight, we can, and should, advocate for our patients. To do so it to take on someone else’s struggle as our own. And when we speak out from a truth rooted in their stories, whether at an institutional, local, or national level, we help amplify their voices, moving them beyond to walls of the exam room.

This work is not about being a do-gooder, or completing a class requirement; it is about committing to a job that requires more than diagnostic skills and memorization of medications. As we discover our strengths and weaknesses, we learn better what tools are available, figuring out how and when to use them. And it is in this creative process that perhaps we will master the art of practicing medicine.