My White Coat
Egg shell coat: / Tread softly, / Quietly. / To not crack the illusion / Of knowledge, / Bold aspirations.
Egg shell coat: / Tread softly, / Quietly. / To not crack the illusion / Of knowledge, / Bold aspirations.
If the analogy between medical training and a fraternity is true, then medical students are the pledges. For many, the most grueling part of this pledge process is the third year surgery rotation where the modified Murphy’s Law is applicable almost daily: anything a medical student can do wrong, a medical student will do wrong.
Such was the start of clerkship, lost in a sea of paperwork and bureaucracy. A mountain of bookkeeping distributed to each student: due dates, boxes to check, requirements to fulfill and all with the threat of expulsion if any part was deemed incomplete. I understand the need to track what we experience for assessment, but the framing and focus of this introduction emphasized what should be a secondary to our learning.
Melissa Palma, a recent fourth-year matcher out of the University of Iowa Carver College of Medicine in Iowa City, IA, graces us with her expert advice on succeeding in medical school and beyond.
In many ways, the students of Class of 2017 have become my second family. In the warm August of 2014, each of us arrived at orientation from different walks of life. We became one in the quiet moments as we donned our ceremonial white coats one after another and nervously found our designated places next to our coating second years. It was not unintentional that we swore the Hippocratic Oath as one — it marked the beginnings of a four-year relationship with each other and our transition from civilian life into medical. It represented an unspoken first moment of camaraderie. It represented the first knot tied in this large professional community.
“Write your name on the paper,” he said. Since he was a senior who’d just gotten into medical school, and I was a simple sophomore who’d chosen to attend the session, I did. “Now write Dr. in front of it.” I complied. “If you’re reading that and you don’t feel anything, medicine isn’t for you,” he said. I looked at it again, my name with a Dr. in front of it. I didn’t feel a thing. I crumpled up the paper, chucked it in the trash and didn’t give it another thought.
I used to work as an anesthesia tech at a hospital in Austin, TX. I was surprised the first time a doctor asked me, his incredulous tone dripping with disbelief, “Why would you want to want to go to medical school?” It wasn’t the last time that happened, it wasn’t exactly making me excited to go to school, and it wasn’t a flattering reflection of the doctors that said it, but physician cynicism about the future of health care wasn’t something new to me, either. People fear change, but I think people’s perceptions about impending change are shaped just as much by their perceptions of themselves, especially the interacting dynamics between themselves and their evolving environment.
A few weeks ago, I was describing my team’s discharge plan to the patient I had been following all week. We had found an anterior mediastinal mass on imaging, and the pulmonologist wanted to follow-up in a week after immunohistological staining came back. I told him we felt he was now stable, and that we would like him to follow up with the lung doctor as an outpatient within the week. He asked me if he should return to the ER to get his appointment.
The words by now flow off my tongue. “I’m Sarab, the fourth-year medical student” comes off in a rhythmic flow without a second thought. My position is comfortable, even simple. I am expected to be there, participate to some degree and occasionally know the right answer — I am, after all, a fourth-year post-match medical student.
The first day of my medicine rotation, I proudly put on my white coat and stuffed its pockets with my stethoscope, reflex hammer, otoscope and a few pocket-sized books to help get me through the day. The stress and anxiety of taking Step 1 was over. I was going to treat patients! Heal the sick. Comfort those in mourning. I was finally where I wanted to be: in the hospital.
What were you doing on Wednesday, Feb. 25, 2015, at 9 p.m. EST? Were you taking a bath? Were you having a meal? Most people were probably watching their favorite television show, having quality time with their families or reflecting on the day’s happenings. However, about 20,000 medical students and medical graduates in the United States collectively held their breath at 9 p.m. EST.
Midway through my internal medicine clerkship rotation, I was finally starting to feel like I had the hang of things. I was warned of the insurmountable amount of knowledge we would need to pick up, the tiring nights on call, and the constant uncertainty of our actions. But I was also told that it would be the first time I would feel like a doctor.