“From now on,” our deans told us at orientation, “society will see you as a doctor. Sometimes you may not feel like one, but that is what you are becoming. This week marks the beginning of that transition, which will continue in the months and years to come.”
Dear medical students, I’m sorry. You had just finished two years of didactic learning and couldn’t wait to feel like a “real” doctor. You were finally starting your clerkships, that is, finally working with patients and getting deep in the trenches.
When pre-med and medical students think about where to attend school or where to apply for residency opportunities, they also undoubtedly consider the hard work, dedication and sacrifices required along the way. But how often are they thinking about location in this process?
“What’s the matter with everybody?” asked Mrs. Palmer, a hopelessly demented woman with water wells for eyes. She had just endured her third consecutive tongue-lashing by the bulldog masquerading as a nurse anesthetist.
This path has been far from cookie cutter, / From being kneaded and rolled / By demanding needs to fulfill multiple roles, / I can’t help but wonder, will I make the cut?
When I started medical school, I was most excited to start learning again. Having spent the last couple years as a teacher in a classroom, I sorely missed the experience of being the student. Reflecting on my college days, I missed the intellectual conversations generated in our seminars, hours poring over literature under dimly lit alcoves of Sanborn Library, even the far-too-frequent all-nighters spent hashing through complex biochemical pathways with my study group.
During my first year of medical school, I had the privilege of speaking at several high schools and colleges. The purpose of these interactions was to shed light on what I did to matriculate into medical school, my experiences as a medical student, and to answer any questions. No matter where I went though, one question always followed: “What is the hardest part of medical school?”
About eight months into my first year of medical school, an incoming student asked me how to prepare for the upcoming journey. I could relate to the panicked, excited feeling of the duty to prepare for medical school after an intense visit day. Yet, instead of defaulting to my ingrained answer of, “Nothing can prepare you for medical school,” which I believe was not in the student’s interest to hear, I carefully considered her question and answered, “It’s very important to be a good listener.”
Medical school is a constant, never-ending cycle between success and failure — sometimes one occurring within moments of the other. To be a medical student is to fail. We fail at the small things: working out three times a week, being on time for a friend’s birthday dinner, working on the research that has been on our desk for months. We also fail at the big things like exams, practical skills, asking for help when we most need it and sometimes letting ourselves sulk for too long.
One after the other, day after day it seems, I find myself in a room where the resident is breaking the news of terminal cancer to my patients and I feel an overwhelming sadness belied by numbness. It has only been a week and a half on internal medicine and we have already diagnosed three unsuspecting patients with cancer.
My cadaver has pink fingernails. I saw them on the first day of class, after we pulled back the white plastic sheet with the number “22” scrawled on it with permanent marker, and cut away the damp cloth that had been covering her cold skin. Her arms were folded across her chest, and on her fingers was a sparkly, ballet-pink polish, not chipped or peeling despite having been there for the 13 months since she’d died. I don’t know why it’s there. I don’t know if she painted them thinking she was going to survive to enjoy it, or if she was someone who always wanted to look her best, even in death.
These busy medical students, of which I am one, / are preparing for a road trip, / stuffing our cars full of everything we might ever conceivably need: / Metaphorical band aids, jumper cables, flashlights, emergency blankets,