Contributing Writer
Michigan State University College of Human Medicine
Maseray Kamara is a 2018 MD candidate at Michigan State University College of Human Medicine. She is very active on campus and was appointed to the Admissions Committee by the Dean for Admissions and elected to the Student Council by her peers. Additionally, she tutored first year students in anatomy and biochemistry and spearheaded the fundraiser ‘48 for Flint,’ a student initiated response to the Flint Water Crises. In 2016, she received the Society of Thoracic Surgeons Looking to the Future Scholarship and the AMA Foundation Minority Scholars Award. Maseray is committed to serving underserved and underinsured populations and aspires to be physician who contributes to the medical field through clinical practice, medical journalism, and public health advocacy. Follow her journey in medicine on Instagram @drkamara.
“Please not me,” I pray earnestly. Not me. Not me. I don’t want to become the medical student-turned-resident-turned-physician who loses empathy. The one who loses compassion. The one who takes lives and near death experiences for granted, who quickly learns, as an ER attending once bluntly stated, that “everyone’s a liar.” Not me.
“I know that this is quite upsetting for you, especially since you have been worried about your exam for several weeks.” I took a deep breath and continued hesitantly. I allowed the silence to settle as I racked my brain, trying to remember the SPIKES protocol.
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.
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?
Delirium is a bread-and-butter presentation. The differential writes itself — stroke, infection, intoxication, electrolyte imbalances, shock, organ failure. The intellectual exercise this invites was practically invented for medical students, even if the final diagnosis (dehydration secondary to gastroenteritis) and its treatment (fluids) were relatively mundane.
On the first day of my psychiatry rotation I was anxious, and like most students I worried. I worried I would not have anything to say and I worried I would say too much. I worried I would say the wrong thing at the wrong time and I worried that my words would be more consequential than I ever intended them to be. I worried about my worry.
In medical school nowadays, there is a heavy emphasis on perfecting a physician’s demeanor when interacting with patients. Classes on essential patient care focus upon the social constructs of medicine, allowing permeable medical minds to ponder over various patient-care scenarios and determine the perfect method of one’s bedside manner. I used to believe such classes were ludicrous.
Peering around the door anxiously, my eyes connected once again with the receptionist. After receiving her knowing glance, I once again stepped away from the doorway. It was 9:02 a.m. My first experience shadowing a pediatrician and interviewing patients was slated to begin promptly at 9 a.m.
Seeing this dialog box, which pops up on the hospital’s electronic health record program, is never a surprise. On the list of patients whose charts I’m supposed to review for my summer research project, the deceased ones are highlighted in grey, setting them apart from the otherwise black-and-white list of names and medical record numbers.
White gloves on black skin. The fingers of my gloved hands still interlaced, still resting tensely over her sternum. Elbows still locked. Frozen in the position endlessly refined during CPR training. It turns out that blood flow is important for catheter angiography, which presents a challenge if your patient has no heartbeat. Has not had a heartbeat for 45 minutes.
Medical school is terrifying. This is not something I feel like I am supposed to admit — or let alone feel — because it conveys insecurity. For all the learning we compress into our days as students, we operate in a constant state of not knowing. Perhaps paradoxically so, uncertainty itself seems to be guiding us down the path laid before us. It is as if we are walking with our hands stretched out in front of us, groping in darkness. Every day, we face the unfamiliar, not just in terms of knowledge, but also the larger questions of whether we are turning down roads that feel true to us.
I underwent my first transsphenoidal hypophysectomy, fully believing in the capabilities of my neurosurgeon, who had years of experience and training from a reputable institution, hoping that my surgery would be a success and cure me of Cushing Disease, which had turned my life upside down in its course the past half year.
Columnist
David Geffen School of Medicine at UCLA
Tiffany is a medical student at David Geffen School of Medicine at UCLA, class of 2019. She graduated with a BS in Microbiology, Immunology, and Molecular Genetics from UCLA in 2015. Tiffany is passionate about breaking down barriers between patients and physicians and is an advocate of humanism in medicine. When possible, she loves to travel and experience the culture, landscapes, and food from different places.
The Patient | Physician Perspective
Lessons learned from both sides - A column exploring the qualities of a physician from the perspective of a physician in training, through the lens of a patient.
