Doctor's Orders, in-Training 10-Year Anniversary
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To Me, Ten Years Ago, by T. N. Diem Vu, MD

This April marked the 10-year anniversary of the founding of in-Training, and we invited all members of the in-Training family to contribute articles and other artistic works to celebrate our first decade as the premier online peer-reviewed publication by and for the medical student community.

Dr. T. N. Diem Vu, MD is a surgical critical care fellow at Mayo Clinic and contributes this article as a former in-Training writer and columnist, and featured author in our print book in-Training: Stories from Tomorrow’s Physicians, Volume 2.

Ten years ago, I stepped onto the grounds of my medical school for the first time. I remember there was so much anxiety — I was anxious to become a student doctor, anxious to choose a specialty, anxious about my own insecurities around my impressive and brilliant classmates.

I wish I could go back in time and sit down with my younger self at my favorite coffee shop. I’d treat her to a hot matcha latte with honey and vanilla (it’s going to change her life) and tell her everything is going to be okay.

I would tell her she will find a community in this new town and new school, and form lifelong friendships. I’d advise her to try to keep writing and drawing for as long as she can, even though she thinks those are quirky hobbies with no relevance to something as serious and academic as medicine. I would assure her that she will pick a specialty that she enjoys like no other, with no regrets.

But surely everything isn’t perfect, she’ll ask me. Well, sure. I may tell her about the pandemic of 2020, climate change, TikTok, though I’m not sure if those will send her into a panic. In other news, I will tell her that the job interview process was on my mind recently. It’s a process that is less frenetic and rigid than interviewing for medical school was, but it comes with its own challenges. But one theme she will find when she interviews for residency, fellowship, and for jobs is that people are so much more likely to ask her questions about her hobbies and medical humanities than about her research or board scores. This is when she would give me a blank stare—at this point, she hasn’t even heard of ‘medical humanities.’ My cue to explain.

There is a much more academic answer to describe what the medical humanities are, but since I would be talking to myself, I will keep it simple: medical humanities is a way of tying your love of the arts into your work as a doctor and an educator.

The first example of this that comes to mind is storytelling. She has dabbled in creative writing throughout college, some of it fiction and some of it nonfiction, but none of it anything she felt related to medicine. But as I’d tell her: in medical school, residency and beyond, being able to tell a story concisely and clearly is always useful. There is no better way to put a colleague to sleep or to raise a surgeon’s blood pressure by roundabout babbling about a patient instead of telling an evocative story with a narrative flow that keeps the listener’s attention. Further, copying and pasting daily progress notes like an automaton is a surefire way to create medical errors and receive confused phone calls from other care providers. So keep writing, keep reading, I’d tell her. She may need to put the plans for a 30-volume epic fantasy series on hold…but I’d suggest writing about her own experiences to relax, or write whatever she wants for fun. Read for work, but do try to read for pleasure. Good storytelling is good storytelling.

The second way the arts have crawled into my life in surgery is through drawing. I’ll tell her she is used to drawing doodles of cats and plants in the margins of school notes, but dedicated drawing is an incredible tool. Try explaining Whipple anatomy to a patient who doesn’t even know what a duodenum is, and then try it with drawing pictures. Don’t expect to draw a Netter’s atlas, but sometimes the blocky schematics can be more helpful for patients. It’s an amazing feeling when you draw a simple diagram and the patient says, “Wow, I get it!” So I’ll tell her to keep drawing as much as possible. Draw in anatomy class. Draw on rotations. Draw surgical steps. Draw for your patients, for your students, and for yourself.

The third and most difficult way — but also the most useful — that the arts will help her journey through medicine is through performance. I know she is shy and quiet. Just the thought of speaking in a room full of people makes both of us tremble. But I’d explain that medical schools are offering more and more improv and theater courses, and she must absolutely take any such opportunity. Speaking in groups of people is something she will have to do on rounds, when giving lectures, presenting research, making operating room briefings and commanding code resuscitations. Theater exercises will help her practice projecting her voice and her confidence. Improv will also make her practice thinking quickly on her feet. In basic improv exercises, one is encouraged to respond to all scenarios with, “Yes, and…,” and avoid throwing up hands in defeat. That’s not exactly something one can do when resuscitating a bleeding trauma patient, either.

I would also say the humanities were the anchor that saved me during my medical training from being swept out too far to sea. I wouldn’t lie to my past self; I would tell her that she will have thoughts of abandoning medicine. The imposter syndrome, the burnout from patients not wanting to see “just a trainee,” the exhaustion caused by long hours, the pain of deaths and complications of patients.

But just when my past self starts to get fidgety in her seat and asks the waitstaff for some extra water, I’ll tell her that in the next 10 years she will do incredible things that make it all worth it. She will be there for the birth of babies, and she will help people die peacefully. She will recognize findings on CT scans and realize how far she has come from not even knowing what the gray blobs on the screen mean. She will transition from struggling to understand treatment plans, to coming up with her own and seeing their results. She will sew organs into transplant patients, resect tumors from cancer patients, and relieve obstructions in malnourished patients. Her hands will control robots and endoscopes. She will help children find laughter in times of illness, and help adults find understanding in times of fearsome unknowns. She will insert lines to deliver life-saving medications, and remove drains that punctuate patients’ healing.

The humanities will show her the meaning of “the art” of medicine and appreciate these powerful human experiences. Storytelling allows her to document them, drawing will help her to teach others about them, performance will force her to engage in them. The humanities will allow her to enjoy the privilege of being a physician while still being herself.

So before my time is up (who knows how this works, if it’s a fairy godmother kind of deal or a multiverse timeline situation), I would encourage my past self to hang onto the humanities as best she can. I will try to as I move forward, too. As I make this commitment, maybe that’s when the me from 10 years in the future sits down to join us at the table. I know I’ll have a lot of questions for her.

T. N. Diem Vu, MD T. N. Diem Vu, MD (8 Posts)

Columnist Emeritus

Mayo Clinic

Dr. T. N. Diem Vu, MD is a surgical critical care fellow in the Mayo Clinic Department of General Surgery. She graduated from Mayo Medical School in the Class of 2016. She completed a BS in molecular & cellular biology with a minor in writing seminars at Johns Hopkins University in 2012. Her interests outside of medicine include illustration, writing, singing and playing ukulele, photography, film, food, books, and spending time with loved ones.

Med Student Shadows

As medical students, we shadow physicians to learn about the nature of medicine from them and their patients. In this column, Diem traces her own shadow, preserving and illustrating her experiences--in class, in the hospital, and in between--as a medical student.