Despite its omnipresence, Time seemed to be in reliably short supply throughout the year. I keenly felt its absence: less time to cook and clean. Less time to exercise; less time to date. Less time to read and to write. And it frequently seemed that my peers had a command of Time that escaped me. They finished novels, ran half-marathons, and published papers all while possessing a medical knowledge superior to my own. The only indulgence Time afforded me was enough to follow the aforementioned Republican primaries—a gift that I would have gladly gone without.
A Silver Bullet / The tiny guns held by my little action figures / still remind me of that god forsaken trigger.
As physicians, it is our responsibility to understand these serious implications and to help these patients live as fully as possible. A patient is not just his or her numbers — their vitals or their lab values. A patient is not just an MRI reading or a CT scan finding. Every individual has a mind, and we must take into account mental health when treating these patients because if left untreated, they can have dire consequences. More importantly as people — as humans of society — we must not stigmatize these illnesses.
Patients don’t always have to let us into their rooms. As medical students, I think we don’t give enough acknowledgement or praise to the vulnerable individuals that allow flocks of medical students to bumble around their bedside. But our perceived ineptness is the last thing on the patient’s mind; a friendly face that is willing to listen to their story is just as important.
“Great, six weeks of crazy people!” This is the sort of attitude with which I went into my psychiatry rotation. Couple this with the fact that while most schools only have four required weeks of psychiatry, my school has six weeks. Of course, I would have more free time compared to other rotations — it is called “psychation” for a reason — but at what cost? Mental illness was something that made me uncomfortable.
Friday afternoon psychiatry didactic sessions are a holy time among medical students. A golden weekend rapidly approaches and the afternoon, typically spent trudging through paperwork, is instead spent listening to residents talk with minimal effort required to listen. At the end of a frantic third year of rotating, sometimes it’s nice to just set the busy work down and take it all in. Granted, I’ll actually have to learn the info at some point before the test, but for one afternoon it’s nice to be passive.
The beginning of third year clerkships is an exciting time for medical students. The first step of my licensing exam was finally behind me and now I could focus on applying the knowledge into a clinical context. I had heard a lot of stories about the third year of medical school. Perhaps what stood out most were the reflections shared with me when people witnessed death for the first time. From full codes to hospice patients, something about death seemed to draw out the most intense emotions and thoughts that can change lives forever. Although I always try to do the best for my patients, I knew it was inevitable that I would come across death. I wondered what profound thoughts and reflections I would have when I experienced it for the first time. It wasn’t too long before I was called to do CPR in the emergency department and I found it did not play out as I expected.
She was a petite, otherwise well-appearing woman, apprehensively sitting at the edge of the examination table. Hoping to mask my nervousness about this first, intimate patient encounter, I inquired about the reason for her visit. She told me that she was here to discuss a hysterectomy. She shakily explained her two-year history of heavy, painful menstrual bleeding. She hoped that the hysterectomy would be her saving grace. The insistence on this procedure made me suspicious of stirring waters beneath calm surfaces, so I probed further.
The first day of my medicine rotation, I proudly put on my white coat and stuffed its pockets with my stethoscope, reflex hammer, otoscope and a few pocket-sized books to help get me through the day. The stress and anxiety of taking Step 1 was over. I was going to treat patients! Heal the sick. Comfort those in mourning. I was finally where I wanted to be: in the hospital.
“He always does this, it’s unbelievable!” My preceptor’s voice was unmistakable. We had just finished our first case and I had momentarily left to get some coffee. “This is getting unacceptable, someone needs to bring this up to the board!” I had never seen him so worked up after having worked with him over the course of the week.
In the rest of the house, the noise of the party is deafening: the clink of glasses, the sizzle of burgers on the grill, the excited cries of relatives reunited after long absences. But in the bright light of the kitchen, Mark is talking to me without sound. He presses his right hand over his left then moves up its length, separating his thumb from the rest of his fingers as he goes replicating the open and shut motions of a jaw. “This is the sign for cancer,” he says.
A mere five weeks into my third year of medical school, I met a patient who would leave an indelible mark. Jose was a Hispanic man that teetered between overweight and obese; I am a tall, medium-build Chinese-American who was thin in high school. He struggled with depression during 40 odd years of life; my biggest worry growing up was excelling on the competitive piano circuit. He spoke of a family rife with discord and unhappiness; my family is intact and supportive. He dropped out of college; I want to stay in school forever. He ate rice and tortillas; I ate rice and tofu. We were different but for a moment, our lives intersected.