“Be a duck,” became my mantra throughout medical school, so much so that my mother had it printed onto a canvas and has it hanging on a wall at home in my honor. As a medical student you might think I would be more interested in having the prowess of a lioness, the elegance of an eagle, the speed of a cheetah or the energy of a dolphin. A duck, as most envision it, does not have much appeal; except, however, when swimming. The quote that led me to emulate the duck is Michael Caine’s, “Be a duck, remain calm on the surface and paddle like the dickens underneath.”
Whenever I consider my time in medical school, I am surprised by how quickly I have been able to cultivate a sense of belonging at the University of Wisconsin-Madison, far from home and in a very unfamiliar setting. After all, I grew up in a single-parent household with my dad in a small, weary mill town in central Massachusetts called Ware. He was a carpenter who always carried at least two jobs to make ends meet. I did not really thrive in medical school until my first rotation on the wards, where I was reintroduced to “my kind of people” — patients.
My alarm went off at 4 a.m. in the morning. I begrudgingly pulled myself out of bed, threw on some scrubs, and headed to the hospital. Not a car was on the road. It was the third week of my OB/GYN rotation, and I was on the infamous gynecologic oncology service.
In November, I hated medicine. The gray clouds that watched from the sky followed me day after day — to my car, into the hospital, to my car again, and back inside my home. At times the haze was tolerable; an inconvenience, a bother, but no real trouble. Other times, it was suffocating.
When I enter the examining room, Mr. Jones is visibly distressed. His chest heaves as he struggles to catch his breath. I glance at his charts and make note of his chief complaint: chest pain. After a brief introduction, I fire off a barrage of well-rehearsed questions: When did the chest pain first begin? Does it radiate outwards or stay localized in one spot? Is there anything that makes the pain better or worse?
His eyes are hidden beneath a pair of shades. I wish I could see them. A tweed cap, or as I like to think of it, a “grandfather” cap, covers his head. He leans his back against the chair with his hands resting on a cane.
As a medical student, I always carry naloxone in my backpack. Naloxone is the antidote for opioid overdoses, and is readily available at most pharmacies in Boston. My medical school, Boston University School of Medicine, is located near the epicenter of the opioid epidemic in Massachusetts.
I thought about you and your wife today — about how we were neighbors. A fleeting thought chipped away at some mental dam I had constructed, and the details of those months flooded my mind in vivid detail. It was like remembering every little element of a past night’s dream all at once after lunch. I remember meeting you for the first time. We were riding the elevators, and you were lost. You were hushed and panicked as you spoke into your phone: “I don’t know, I don’t know where she is, I just want her to be okay.” The phone was held up by your shoulder as you used your hands to balance on crutches.
There was an elderly man suffering from late-stage Parkinson’s dementia. There was a patient with schizophrenia experiencing a COPD exacerbation. Then, there was Mrs. G, who was admitted for immune thrombocytopenia. She was a retired teacher who spent her time volunteering at her church and caring for family members.
Nothing is quite as strange as the first day of your surgery clerkship. It isn’t just the shock of seeing a living human intentionally cut-open or the unforgettable smell of cautery for the first time — even just getting into the operating room can be an obstacle.
My foray into the wilds of Alaska was part a journey that my classmates and I call “the Safari.” While no African wildlife are spotted on the trip, bears and moose are plentiful, and the journey traverses over a quarter of the United States landmass, from four-room clinics serving towns of a few hundred people to the massive edifices of a level one trauma center and tertiary care university hospital serving five states. For those unfamiliar with the program, the University of Washington is the only allopathic medical school in the “WWAMI” region, comprising of Washington, Wyoming, Alaska, Montana, and Idaho; the school has clinical sites and regional teaching campuses in each of these states. Come third year, students can request rotations in the multiple hospitals in Seattle, or rotate at the regional sites.
It was early in third year and Ms. G was my only patient. I visited her every morning and evening and sometimes in-between. While our discussions had little to do with receptors and pumps, Ms. G taught me some of the most enduring lessons of that year.