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.
Mr. T did not smile at me. No, I didn’t think it was because he was mean or anything; in fact, he was polite and had quite a calming voice. But honestly, it was hard to read someone’s facial expression behind a mask — at least during the first few months of the COVID-19 outbreak.
“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.
Our illness narrative, the COVID narrative, is about so much more than regaining health (though I acknowledge that for those afflicted by the disease, overcoming the debilitating circumstances may be more than can even be hoped for). Returning to Frank’s ideas, our narrative is about rediscovering the voice that was stolen by forces beyond our control.
This feeling of loss and subsequent reflection revealed to me something fundamental about how I experience time in my own life. As I depart the anatomy lab, I stand on the shores of time’s river and gaze into the clear water’s surface. In it, I see a reflection of growth and of internal transformation — a reflection not of who I was but of who I have become. I emerge not only learned in anatomy but also with insight into the impact that individuals can have on one another.
Another day passed as I approached the deadline of my latest assignment. Our professor asked students rotating in the ICU to reflect and write up a patient encounter that influenced them deeply.
When I was 17, I went to the gynecologist for a Pap smear because my mom said, “Once you have sex you have to get one.” It felt like punishment, but it was also the only way I had a chance of getting birth control. I went to three different doctors and exam after exam, they kept saying I could have cancer. I did a ‘colpo’ — whatever that is. After that, they did three different procedures on me, three, all to take pieces of my cervix. I don’t remember what they were called or what even happened. All I remember is the pain.
Thank you for your contributions and your readership over the past year. It has certainly been a difficult one, and we are exceedingly grateful that you all used in-Training as a platform to share your reflections, opinions, and solutions. Run by medical students and for medical students, your ongoing support is what makes us a premier online peer-reviewed publication. We look forward to seeing your contributions in 2021, and we’re excited to see where the year takes us (hopefully some place better!).
She was a woman in her early twenties accompanied by her husband. She was a first-time expecting mother at 19 weeks gestation with twins. They had received regular prenatal care and had been doing everything as the doctor had instructed to ensure a healthy pregnancy. She made this appointment because she felt something was off, her motherly instincts already keen.
You were my first patient on my first inpatient rotation as a third-year medical student, which meant that I had absolutely no idea what was going on. I was mostly concerned with trying not to faint during presentations on morning rounds. I stared at your bowl of Cheerios, the cereal beginning to turn the skim milk a pale yellow. Your brow furrowed in annoyance behind your thick glasses.
I proposed a deal to my fellow student on our surgery rotation. “You can have all the other cases today if I get the laryngectomy.”
My agitation grew as I realized I needed to do something. I was a medical student training to be a doctor after all, right? Wasn’t I supposed to help alleviate the burdens of others?