Dear med school newbie...

A couple weeks ago I posted an open-ended letter to a future patient. A couple days ago one of my dear friends, who I've known forever, started medical school. I like the idea of writing to people I know, but writing to people I don't know is just so fun too. It's in that spirit I give some advice to the brand new med school newbies out there.

Dear med school newbie,

First off, congratulations! Not just for getting accepted to medical school, but for accomplishing the goals that mark that journey. The pre-requisites, and letters of recommendation, and community service projects alone are usually enough to scare the faint of heart from ever even thinking of applying to medical school. (Do I dare even mention the MCAT? Ok, I won't.) But not you, friend. You stuck it out. You figured out exactly how much caffeine precipitates palpitations and walked that fine line like an olympic gymnast. You passed organic chemistry - even if it was with a C. You volunteered your time and parts of yourself and hopefully along the way you realized that helping people is really one of the greatest things ever. Which only made your nerdy little heart chase after a career in medicine that much faster. Go you. :)

Right now I wish I could give you a hug and a high five through the internet (get with it, technology!) I also wish I could tell you that the hard part is over. That once you get that life changing letter cementing your white-coated dreams into reality you can take a breath and relax. (Ok, I guess on the actual day that letter arrives you can chill for a bit.) But if I said the rest of this crazy ride was all downhill after getting accepted, I would be a big fat liar. Which is generally something I try not to be. (People like you more and your scrubs fit better. :) )

The reality is that medical school is like a roller coaster. And some days -- like when you pass an exam you were sure you failed, or you manage not to make an ass out of yourself in front of a faculty member -- you are going to feel so confident and sure of your decision to practice medicine. But other days are going to be low. And the stress and workload and never ending list of things to know and study and review will be overwhelming. You may find yourself questioning this particular life choice and doubting your ability to do this whole med school thing.

I wish I had some advice on how to get through the tough days. All I can say is lean into the people who supported you this far. They're still there. Seek comfort and encouragement in your new med school friends - they're in the academic trenches with you! And remember why you wanted to become a doctor in the first place.  Set goals for yourself and chase after them, just like you did when you were still a puny "pre-med." Acknowledge and appreciate your strengths. Work on your weaknesses, but don't beat yourself up over them. And just a couple of med school myth busters for you: Every one struggles with something. No one "barely studies." And no person in a white coat, yes even your esteemed faculty members and attending physicians, will ever know it all.

It's also important to know that medical school is finite. It's not gonna last forever. And, even though I'm only 2 months into clinical rotations, they are so so so much better than the first 2 years. Because those years suck! There really is not use telling you they don't. But again, they only last 2 years. And then they're gone. So learn as much as you can. Say goodbye to the outside world (and your tan. Libraries generally don't have UV lights.), and work your tail off. Because one day you'll walk into a patient's room and lying before you on a hospital bed will be that random disease you read about manifested in a living, breathing person and you will be able to help them. Which is really what all of this med school stuff is about in the first place.

And, when all else fails, and on those days when you "literally can't even," remember PASS = MD/DO.

Now, go put your smarty pants on. We've got some studying to do. :)

Morgan

P.S. This week I really did walk into a room where a patient had one of those "random diseases" we're told as students we'll "hardly ever see." When you get a chance, check out neurofibromatosis. Gotta love those neurocutaneous disorders. :)

Time Machine

I looked down at my watch and felt a small surge of panic rise in my chest. 6:42am. 18 minutes until morning report. 18 minutes to talk to my patient and examine her before I had to be sitting in a conference room on the other side of the hospital.

Mrs. X, can you tell me how your night went?

Mrs. X, did you get some sleep?

Mrs. X, have you had any headaches? 

I began asking my usual battery of questions to a sleepy, semi confused elderly female patient. She interrupted me to say that she needed some water. I hurriedly explained that I would have the nurse bring some in once we were done.

6:47am. 13 minutes.

Any nausea?

Any vomiting?

Again, she asked me for some water.

"I know your throat is dry Mrs. X. We have you on NPO in case we need to do any procedures. I'll have the nurse get you a small cup of water as soon as we finish up here. "

6:51am. 9 minutes.

That time when I looked up from my watch, I noticed Mrs. X gently rubbing her throat, eyes closed. I stopped. I felt like someone had smacked me in the face. Here was an 88 year old female patient, a patient who I had been assigned to follow. A patient who looked remarkably like my grandmother. A patient who was sick and tired and scared. And she was asking me for water. Water.  And all I could focus on was getting the information I needed so I wouldn't make an ass out of my self in front of my attending. Here I was behaving exactly like the type of doctor I had sworn to never become.

I paused. Grabbed her hand and said that I was sorry she was so thirsty. I filled up her cup with a little bit of water (NPO is the worst) and patiently waited while she slowly took a few sips. After she was done I took the cup from her and started over.

I was 6 minutes late to morning report that morning. And I though I can't say that I didn't care -- the watchful eyes of my resident stung a little as I took my seat,  I was more grateful for a lesson learned.  I realized just how easy it is to give in to the endless demands placed on pretty much everyone working in a hospital. I also realized that the choice of giving in to the ever present tick-tock of an over-packed schedule, or taking the time to truly care for the living, breathing human being in front of me will always be just that -- a choice.

Realistically, as a third year medical student, my choices don't impact much right now. Mrs. X would have eventually gotten her water at 7:00am anyways when her nurse came in to administer morning meds. But one day, my choices will have more lasting consequences. And I want them to be positive ones.