All I want to be when I grow up is a doctor

Yesterday I attempted to acquire myself a pair of scrubs. I’m supposed to go on a scheduled observership with a cardiologist who does angioplasties (basically blowing up a balloon into your arteries to get rid of the dirty, dirty plaques from all them Mickey Ds).

So we (T & I) decided it would be a good idea to get a pair. Just in case he let me actually be in the room, as opposed to sit behind the glass like a two year old in time out. The thing is I both fear and hope that I get to go into the cath lab (where they do the balloony-stuff). I’m afraid that they’ll ask me questions…and as I said before, I don’t know much. Actually I know nothing. What's more, this doctor was one of my facilitators for clinical skills. And basically we/he doesn’t need to be reminded of my incompetence in this area:

Doctor
“…blah, blah, blah (whole bunch of complicated medical stuff related to the brain or something) cranial nerve…blah, blah, blah, blah…muscles of the eye? "
Me to self
[blank look on face]
There are muscles in the eye??

So anywho…I’ve decided that I want to see what he does for a living, considering he’s all smart and accomplished and stuff (and maybe because a certain someone had a little tiny crush on him in the beginning)…

I'm kinda nervous. It doesn't help that it’s supposed to be 8 in the morning (much too early to be doing medicine, in my opinion), and if it turns out to be boring (I mean looking at a black and white screen of wormy looking blood vessels for an hour might not be everyone’s idea of entertainment) I may fall asleep. And in my fit of losing consciousness, fall on the patient… what a lady huh?

Back to my scrubs story…so I got the “greens” from the linen lady (whose office is like in the dungeony area of the hospital), and tried them on at home. By the way, they were supposedly “small.” But on me… I think the pants reached halfway up my stomach… Who am I Steve Urkel? I look like I’m five again playing dress up…all I need is my Fisher Price doctor’s bag. What’s worse, I don’t trust that they’ll stay on…can you imagine? Face planting on the patient, AND losing your pants? How graceful…

The Beginning of a Lifetime of Humiliation

It takes a lot of work to get into medical school. The application process has been compared to anything from a meat grinder to a cut throat rat race. There's nothing more (a) relieving, or (b) exciting than finally getting that acceptance letter. I jumped up and down like a crazy woman (well, I was at work when I got the news, so I didn't actually. But DEEP DOWN INSIDE I was doing the Riverdance). I couldn't stop smiling. Someone actually stopped and asked me if anything was wrong (I guess I must have looked a little off). But after the initial euphoria wore off, my first thought was "I wonder how long it'll take for the admissions committee to realize they've made a mistake". Ah, pessimism. My friend.

I had this concept that since med schools are so hard to get into, that medical students must be incredibly intelligent, capable people. And don't get me wrong, most of my classmates would fall into that category. What surprised me was that most doctors didn't expect much from us at all. Case in point: the following is a slide from our respiration block.


AIRWAY ASSESSMENT: FIRST DETERMINE...

1) Is the patient dead?
2) Is the patient dying?

If the patient is not dead or dying, take a history.


Yes. The attending felt it was necessary to instruct us NOT to attempt a history on a deceased patient. Perhaps they have run into problems in the past regarding that particular concept...

Picture the earnest medical student clutching a patient chart in sweaty palms, standing at the head of a body bag.

"MR SMITH??? MR SMITH, CAN YOU HEAR ME? CAN YOU TELL ME IF YOU'RE ON ANY MEDICATIONS? WHEN DID THIS PROBLEM START??? ARE YOU IN ANY PAIN? WHAT PRECIPITATES THIS PAIN? TELL ME ABOUT THE QUALITY OF THE PAIN. DOES IT RADIATE? MR SMITH?? HELLO??? WHAT DO YOU HOPE TO GET OUT OF THIS INTERACTION?"

Anyways. Bottom line. Most doctors' opinions on the intelligence level of the average medical student: low to very low.

Anatomy Lab: Day 1

We met our cadavers today. The hospital chaplains held a memorial service in the anatomy lab before we started, and we were encouraged to think about who these people had been, what their lives had been like, who they had loved.

At our table, the six of us stared at the white bodybag lying in front of us. We could tell from the lumps beneath that our cadaver was short- probably a woman, someone said to break the heavy silence. One of the braver souls reached out and felt the leg through the plastic. "Rigour mortis," he blurted out with a nervous laugh. Body juices were pooling through the zipper of the bag. We decided not to unzip the bodybag just yet, and busied ourselves with our bone box. Bones were less personal. Carpals, metacarpals, phalanges. We pored over each groove and bump of the skeleton.

Our anatomy professor came over to watch our discussion. He leaned his elbows against our cadaver's head as if it were just another piece of furniture as he answered our volley of questions. After he left we looked at each other. We had all noticed his disregard for our cadaver. Somehow, that realization gave us the courage to open the bodybag. We all donned gloves and watched in silent anticipation as the zipper slowly pulled open.

First, the feet came into view. The cadaver was lying facedown. Then the legs, and then more came into view, until we were looking at the back of her head. It was a her. She couldn't have been more than five feet tall, an older woman with bluntly chopped grey hair. She probably had been a grandmother. She looked like she would have looked right at home sitting in a rocking chair in front of a big picture window, knitting booties for the newest grandchild. "Wonder how she died," someone mumbled. Stomach cancer and heart failure. She had been 66.

We decided to name her Nora. Partly because she looked like a Nora, but mostly because none of us knew anyone called Nora. We wanted her to be special. As we were leaving the room, we saw half a cadaver's head, sawed through the middle and sliced off at the shoulder, skinless and grey, discarded on a side counter in a little tray. I barely blinked. The desensitization has begun.

A Whole New World

I think the first thing one needs to admit when you're in med school is that us 1st year kiddies are kinda dumb. Yeah, yeah all you type-A's out there. This is how you got in the first place right, from our nerdy brilliance. But once you’re here, it’s incompetence city.

Case in point – clinical skills. For those of you who don’t know what this means, in first year we have ‘clinical methods,’ which basically teaches us how to do physical exams. Except half the time we don’t know what we’re doing. And that right now what’s supposed to be normal could just as easily be abnormal. 90% of the time, this is how the sessions go down:

Doctor-facilitator
“Okay so today we’re going to practice taking blood pressures…you there…you’re first”
Me to self
Okay [takes deep breath] ... I can do this…I’ve watched ER…
[Trying to look confident while struggling to put cuff on patient and stethoscope on arm]
Doctor-facilitator
"So do you hear the korotkoff sounds?"
Me
[Confused look on face…the wha sounds?]
"Uh, no…actually I hear nothing"
Doctor

[looking clearly confused]
"What? Are you sure? How is that possible?...

[Looks at my stethoscope]
… uh yeah you’ve got it turned the wrong way."
Me
Oops…

Worse yet, don’t pretend to hear or feel something if you don’t. It won’t end well. Your facilitator will know, and you’ll just end up looking like a complete ass.

Doctor-facilitator
“So you there med student, listen to this patient’s chest”
Me to self
Oh no, he’s talking to me…okay, calm down…listen to the patient’s chest
[Puts on stethoscope…do I even have this on right? Procedes to ‘auscultate’ chest]
I hear nothing…oh god, this patient has no heart beat! Oh my god, he’s dead!!
[starting to panic]
Doctor-facilitator
“So do you hear that…?”
Me
“Um….[looking around at others in groups desperately for help]… yes, yes I do… "
Doctor
“What does it sound like?”
Me
Oh crap…make something up…
“Yes…I heard S1, S2" (normal heart beat sounds – basically lub-dup)
Doctor
“Yeah…well…[trying not to laugh or sigh out of frustration in my ineptitude]…no…try again…"
Me
[Laughs nervously] Okay…try again… “Um, breath sounds?
Doctor
[Sighs to self]…”uh, no…clearly this patient has a pansystolic mitral valve murmur”
Me to self
Kill me now…

So there you have it. Be comfortable with feeling like you know nothing. It’s going to last for a while…

5 Ws & How?

Hello, welcome to second opinion. As a first post, we thought we’d do a quick introduction.

Basically we’re two 1st year medical students who wanted to create a way to record our experiences in this crazy journey that is medical school. It’s a way to let each other, as well as friends & family, keep updated on what are the goings-on in our lives. It’s our journal that’ll help us remember all those funny little stories 10-15 years from now when we’re “real” doctors with all the plaques, scalpels and real-life patients, not just those paid actors who pretend to be sick…

Okay, let’s be honest, it’s because we love procrastination & (let’s face it) this seems a lot more productive than watching ER, House or Scrubs on TV all day long…

So thanks for reading, and we’ll try to be as entertaining & interesting as we can. Enjoy!

Health Information Privacy Code

Due to patient confidentiality, all medical school-related stories we tell involving patients, family members, health care workers, students, etc. have been changed in some way for privacy reasons. We will usually alter one of the following: name, gender, age, diagnosis, or the order in which certain events took place.


On a lighter note, look forward to our introduction post!