The alarm rings. Its shrill screech jars him out of sleep and his eyes slowly open. He lays there a moment, listening to its piercing repetition. He considers falling back to sleep. After a moment he rolls out of bed and his feet hit the cold wood floor. He touches the top of the clock and the room falls back into silence. As the covers fall away, the chill from the morning air touches his skin, causing the hairs to prickle. He stands and steps over to his window and pulls the blind up. It’s still dark and snow coats the roof outside his window. It’s 7:00 a.m.
He grabs his towel and walks into the bathroom. He turns on the shower and steps in. As the water turns hot, steam rises from the floor of the bathtub and begins to fill the room. The mirror clouds over. As the water washes away the sleep, he begins thinking of the day ahead. He finishes his shower, stretching the last seconds out to enjoy the rush of hot water. He turns the knob and with a rattle and a squeak the water stops flowing. He continues his morning routine. Contacts, hair, teeth, clothes.
Downstairs his roommates are already ready. They eat their bagels and drink their coffee in silence. The glow of the television dances across their faces. The morning light is creeping in under the drawn blinds. He walks downstairs and pauses to see what’s on the television before continuing to the kitchen. He drinks a glass of water and gathers his things. His roommates reluctantly turn off the television and put on coats. It is 7:45.
The walk to school is cold. The three students walk in single file, their footsteps muffled by the night’s snowfall. They pull their chins down tight against the morning wind and trudge towards the hospital. It looms ahead, a vast brick structure rising from the snow. It steams and glows in the early morning light. Soon they draw near and the electric doors slide open for them, greeting them with a blast of artificial heat. They stomp their feet and walk in.
Immediately they are greeted by the bustle of the day. Hundreds of people walk the halls and fill the air with jumbled conversations. Doctors whisk by in white coats, workers push tubs of linens down the halls. The students weave between administrators and dodge carts as they turn corners. They loosen their jackets against the warmth of the hospital. Soon they arrive at a sprawling glass and brick atrium. It opens before them, filled with morning light and echoing conversation. Students like them stand in small groups, laughing and talking before the start of class. It is 7:55.
The three students make their way to the auditorium that is nestled at the far end of the vast glass room. The students join their classmates. The conversation rises and falls as everyone finds their seats. Soon, a professor walks in and the conversations fall to mumblings.
Before long the professor steps forward and asks for the class’s attention. He starts to speak, his notes towering behind him on a brightly lit white screen. As he begins the class digs in their bags and bring out notes, computers, books. The mumblings die to whispers and soon the only noise in the room is the professor’s deep monotone voice. It is 8:10.
He slouches in his seat and before long drowsiness settles on him. It is a warm blanket that envelops him and ushers him back towards sleep. The professor’s droning voice and his giant glowing notes lull him into a trance. The student is aware of the lecture but he does not gather any of the details. He stays this way for some time. Near the bottom of the hour, something prods at his sleepy mind. Perhaps it is the movement of a neighbor or a rustling of papers that jars him from the spell. He jerks awake, inhales deeply, and sits up. He immediately focuses on the lecture. After a few minutes, drowsiness finds him and attention departs again. He looks out over the class, scanning over the familiar faces. Some of them are trance-like as well. Soon he rests his chin on his propped up arm and drifts quietly back to catatonia. It is 8:52.
Soon, a break in the lecture brings him out of the daze for a second time, and he stands to get something hot to drink. Getting out of his chair helps to wake him up, and the thought of hot tea carries him to the atrium. There he mingles with other students. The interactions perk him up and he finds himself awake and ready for the next lecture. He gets his tea and returns to the auditorium. The professor sets in on his next topic.
As the lecture continues, the student stays more focused. It is always this way with the second lecture of the day. Even so, he often finds he learns only 3 or 4 parts in 100 from the lectures. The professor’s monologues are more useful as a guide to focus his studying in the evening when he must learn the other 90 parts.
The professor’s talk draws on into the afternoon. It is almost 12:00 before it is finished and nearly 100 slides have been covered. The lecture is finished with no ceremony and the student closes his notes and books. He packs his things and pulls on his coat. He waits for his roommates to do the same and together they exit auditorium and start for home.
They leave the hospital and step outside. The meager sunlight is amplified by the white snow and forces them to squint into the day. They begin their walk. The snow has been mostly scooped away by men with shovels. On the way home they debate the difficulty of the day’s material and comment on how much they plan to study. They are all wishing they were going home to relax.
At the house they prepare lunch. Together they sit with the television and eat. They finish and go upstairs and put on more professional clothes. They make sure their ties are knotted correctly and gather their tools into their white coats. Each of them takes their leave and departs to separate clinics for the afternoon. It is 12:45.
There is a palpable change in the student’s demeanor from the morning. Before he had been a passive learner, allowing the words and pictures from the lecture wash over his open mind. Now, he is more alert and ready to step into an active work environment. He parks his car and walks across the lot. As he steps through the front doors of the clinic his mind shifts from learning to doing. He greets his preceptor and she tells him of the day’s schedule.
The student is to see four patients on his own that afternoon. He steps into the exam room to see the first patient. He turns and looks at him expectantly. His heart flutters at the beginning of the interview but after the first question he settles into his routine and the training takes over. He sees four new faces and conducts interviews and basic physicals on each. He tries his best but makes mistakes. The patient does not usually notice.
After finishing with each patient the student steps into the hall, his heart fluttering again as he prepares to speak with the doctor. He gathers his thoughts and steps into her office. As he presents each case a film of sweat grows on his back and his pulse quickens. He remains calm on the outside. Sometimes he presents well, sometimes he doesn’t. The preceptor stays patient and the student learns much without realizing it. Soon the day is ending. The student leaves the doctor’s office after his final patient. It is 5:20.
He loosens his tie and drives home. He steps through the door and greets his roommates and falls onto the couch with them. They are all exhausted. Their minds are heavy and their bodies tired. It’s time for a break. They laugh and joke over the background noise of the television, each beginning to feel better and better about their day. Soon they prepare dinner together. One has fish, another a burger, the other a sandwich. They draw dinner out, but they know they must finish before too much time is spent. Duty begins to tug at their minds and they accept their fate. They put away the dishes and head reluctantly upstairs. It is 7:15.
The student steps into his room and sees the bed unmade as he left it that morning. He sighs and sits down, pulling his books and notes out. He opens to a page and pulls up the professor’s notes on his computer and begins. As he sinks into the lecture his mind grows more and more alert. It sharpens and becomes focused, leaving behind distractions. He is no longer tired. He has reached his most attentive state of the day. He pours over his notes and copies down important parts. He bends over his desk until his back hurts. The students only take the shortest of breaks to jeer at each other. They mock one another for studying too much. Their evening goes on like this for hours. Eventually, they have covered all of the day’s material and they feel comfortable. It is 10:40.
He steps away from his desk and begins his nightly routine. Pajamas, teeth, contacts, exercise. He says goodnight to his roommates and goes to his room. He shuts the door to his room and does sit-ups and push-ups. As he sits on his floor, breathing heavily, his mind begins to slow. Drowsiness creeps over him. He stands and goes to his bed. He picks up a book—something simple and mindless, a break in his day for pure entertainment. He reads for twenty minutes before his eyelids become too heavy to keep open. He closes the book and turns off the light. It is 11:50.
He lays in bed and stares at the ceiling. He feels his bones settle and his muscles relax. His mind is quiet and his eyes begin to fall shut. Sleep quickly overtakes him.
The alarm rings. It is Tuesday.
Contributing Writer Emeritus
University of Rochester School of Medicine and Dentistry
Kelle Goranson grew up in rural Iowa and attended the University of Iowa in Iowa City where he received a degree in biomedical engineering. He is currently a Class of 2015 medical student at the University of Rochester School of Medicine and Dentistry.