some observations on 2nd year
I knew the second year of med school would be difficult. I'm sure I enjoyed being dramatic about predicting this. I'm sure I've said "it's going to be harder than cancer" and that "second year is the thing I have to survive to get to the good stuff". I'm sure I then looked off into the distance like Luke Skywalker in his pajamas on Tatooine, deciding to man up to the challenge.
I was right. This year of endless studying and exams and thousands of bland words to memorize is the hardest thing I've ever had to do, and I'm surviving it. I have to find a way to tell amlodipine from amiodarone. Ondansetron I can remember, because it sounds like one of Santa's reindeer. Maybe you remember the game "Dead or Canadian?" from MTV's early years? Now I play "Foot Bone or Antibiotic?" If I make the mistake of thinking I know enough about herpes or T cells for tomorrow's test, the test exposes my folly. Study fast, study more, take a test, do it again, do it again.
At the end of classes in May, I'll take my first board exam, which I think is six hours long. My better classmates do 200 prep questions PER DAY for this exam, starting a long time ago. The rest of us talk about when we'll be able to start doing prep questions along with scrambling like rodents to pass the next school test. I fear these prep questions, because they want me to remember things from last year, like...um...things about...metabolism? Did we study metabolism? This six hour board exam will result in a score that is the single most important factor in my competitiveness for residency. And I'm blogging about it, instead of doing 200 prep questions, in the 90 minutes I have before the next thing I have to do.
This year has some neato stuff too.
I just finished my 12th session with a family medicine doctor out in Virginia Beach. At my first session, I was worse than useless. I'm sure I added an hour to his workday. I did not know what any of the medications were, I did not know how to get anything accomplished with a patient. My stethoscope didn't leave my too-white coat. Worse, my classmates were all excited about getting things done in their first session, like finding a heart murmur. I found the bathroom?
On Tuesday at my final session, I was somebody else. I had the slightest inkling of credibility, sitting knee to knee with patient after patient, getting the story, getting the details straight. Laughing, often. Six months ago, I was unable to imagine that I'd ever be comfortable reaching for the throat of a stranger, that this would ever be comfortable for the stranger. Now the reaching is just work, expected, performed. It's a question needing an answer. It's easy to explain what I'm doing and why.
I can't begin to describe how much I love knowing what's under the skin, and how fun it is to try to find out what's going on in there. Heart sounds, bowel sounds. My hands spread apart by a deep breath, the echo of a finger tap on a lung, the confident look on a woman's face when she denies pain with my fingers pressed eight inches into her stomach. Pictures in books, images onscreen, cadavers in the lab, animations on youtube, all of these are detached, unreal. But in a living person who is trusting me to answer questions with my hands and my senses, then a carotid artery sitting behind a thyroid, the motion of bones in a joint, the change in the sound of a heartbeat from the third rib space to the fifth, the shine on an eardrum, these are all like new friends, continuing a conversation that will never stop being interesting or having more to say. We never need to talk about the weather.
I was right. This year of endless studying and exams and thousands of bland words to memorize is the hardest thing I've ever had to do, and I'm surviving it. I have to find a way to tell amlodipine from amiodarone. Ondansetron I can remember, because it sounds like one of Santa's reindeer. Maybe you remember the game "Dead or Canadian?" from MTV's early years? Now I play "Foot Bone or Antibiotic?" If I make the mistake of thinking I know enough about herpes or T cells for tomorrow's test, the test exposes my folly. Study fast, study more, take a test, do it again, do it again.
At the end of classes in May, I'll take my first board exam, which I think is six hours long. My better classmates do 200 prep questions PER DAY for this exam, starting a long time ago. The rest of us talk about when we'll be able to start doing prep questions along with scrambling like rodents to pass the next school test. I fear these prep questions, because they want me to remember things from last year, like...um...things about...metabolism? Did we study metabolism? This six hour board exam will result in a score that is the single most important factor in my competitiveness for residency. And I'm blogging about it, instead of doing 200 prep questions, in the 90 minutes I have before the next thing I have to do.
This year has some neato stuff too.
I just finished my 12th session with a family medicine doctor out in Virginia Beach. At my first session, I was worse than useless. I'm sure I added an hour to his workday. I did not know what any of the medications were, I did not know how to get anything accomplished with a patient. My stethoscope didn't leave my too-white coat. Worse, my classmates were all excited about getting things done in their first session, like finding a heart murmur. I found the bathroom?
On Tuesday at my final session, I was somebody else. I had the slightest inkling of credibility, sitting knee to knee with patient after patient, getting the story, getting the details straight. Laughing, often. Six months ago, I was unable to imagine that I'd ever be comfortable reaching for the throat of a stranger, that this would ever be comfortable for the stranger. Now the reaching is just work, expected, performed. It's a question needing an answer. It's easy to explain what I'm doing and why.
I can't begin to describe how much I love knowing what's under the skin, and how fun it is to try to find out what's going on in there. Heart sounds, bowel sounds. My hands spread apart by a deep breath, the echo of a finger tap on a lung, the confident look on a woman's face when she denies pain with my fingers pressed eight inches into her stomach. Pictures in books, images onscreen, cadavers in the lab, animations on youtube, all of these are detached, unreal. But in a living person who is trusting me to answer questions with my hands and my senses, then a carotid artery sitting behind a thyroid, the motion of bones in a joint, the change in the sound of a heartbeat from the third rib space to the fifth, the shine on an eardrum, these are all like new friends, continuing a conversation that will never stop being interesting or having more to say. We never need to talk about the weather.
posted by Cy at 3:26 PM
3 Comments:
Cy, so nice to read another installment. In training for any profession, it is fascinating to mark the change in language....from "them" to "us" as we describe members of the profession. To go from observer to performer is awesome. I had the honor of hearing Dr. Abraham Verghese discuss the physical exam and how important it is to the patient and the provider. He is a wonderful clinician, writer, physician and teacher. Best wishes as you develop in your role. Love, Anita from Seattle, nurse practitioner and human being.
Thanks for sharing about your journey through med school. I had been wondering how things are going for you. You've got a heart for the work and for people, and that counts a whole lot! Best wishes as you continue your adventure!
Cousin Bob
Dear Cy, you lovely open being, you. Thanks for sharing your wonder, fears, and strides. Reading your writing is almost as good as a conversation with you - I appreciate the connection. I've been thinking of you lately as we've begin our search for a midwife & doula (no, not preg just yet. wink.). Cheering you on always, and so very excited for you.
April
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