Our Past is Our Future
We often find inspiration in our ability as humans to create anew. I too fall prey to the promises of New Year resolutions and birthday candles, beckoning to us with the allure that our future rests in our hands.
We often find inspiration in our ability as humans to create anew. I too fall prey to the promises of New Year resolutions and birthday candles, beckoning to us with the allure that our future rests in our hands.
It is Wednesday afternoon and I have one last annual visit for the day. As I enter the room, a slender 27-year-old woman wearing a white t-shirt and baggy blue jeans sits in the chair across from me.
In this Q&A, we feature the founder of MedEd Models Dr. Timothy Dyster. Currently a fellow in pulmonary and critical care medicine at the University of California, San Francisco, Dr. Dyster also serves as a resident editor for the Journal of Graduate Medical Education and is the lead contributing editor for the first edition clinical handbook, Huppert’s Notes. He shares his thoughts on medical education and advice for medical students looking to foray into this field.
I was the student on the pediatric surgery service consulted to monitor her during her hospital stay — making sure we were ready to intervene if her esophagus ruptured and all that. After admitting her to the floor, we attempted to contact her parents. Mom was somewhere in Illinois, Dad doing I-still-don’t-know-what in Canada, both completely unaware that the life they each helped create was potentially in jeopardy at a Southeast Michigan hospital.
“What about my sugars?” she asked. In all honesty, since she was not hypoglycemic, I had not examined her specific blood glucose level or hemoglobin A1c too closely. Scrolling through the extensive list of her lab results, I spotted them and felt a knot form in my stomach.
I heard about the blood / that you described as a flood, / and the terrible stomach pain
Lots of people get bigger bellies as they age. My aunt used to say it was because of all the love in your life building up. This man noticed his belly was growing a little more than expected.
Freud supposedly understood himself as a surgeon of the mind, dissecting his patients’ mental anatomy through the process of psychoanalysis. I found this comparison appealing, so when I started the psychiatry clerkship in my third year of medical school, I approached the interview in psychiatry as analogous to a surgical procedure — efficient, scripted, precise.
“I’m sorry that you have to see me this way,” said Ms. A as we exited the examining room. Twenty minutes earlier, Ms. A had been laughing and cracking jokes while my attending physician and I obtained her medical history and life updates.
Many of us had careers in medicine before beginning this arduous journey of medical school. We were nurses, technicians, EMTs, CNAs, researchers and more. We enjoyed a few years of steady pay and real-world lessons before we transitioned back to textbooks, lectures and rotations.
A 5-year-old African-American boy presents to the emergency department with left leg pain. His leg is exquisitely tender to palpation… If I read this vignette in the first year of medical school, I would have navigated to the multiple-choice answers to select anything related to sickle cell disease. The question writers are stating that the patient is Black, young and has a painful limb — this is not a difficult diagnosis.
As the door swings open, it hits the chair that was shifted more than usual. / Next to the computer sits a 94-year-old woman in a wheelchair / who is here for one last visit.