There are a multitude of reasons why this year has been better than last (Really, it's been a lot better! Have I not mentioned that? Yeahhhh I guess I tend to blog when things are bad... but it's true. So far this school year I haven't once googled "Radio City Music Hall Rockette Audition Requirements," or "Any Grad Program Anywhere Focusing in Anything Non-Medical."), but I think paramount among these is the excruciatingly long-awaited turn of the curriculum towards the clinical.
There was a time about a month ago when I looked up from my lecture notes and thought, "Oh... oh right, we're going to be doctors."
The lecturer was talking about "patients" and "examining" these "patients," and telling us how to use this thing I've seen around, but was otherwise unfamiliar with... I think he called it a "stethoscope"?
Silly me, I thought I was here to read esoteric accounts of basic science endeavors and critically analyze the flaws in each and every laboratory study conducted ever. You know, when I wasn't compiling lists of tests to administer for diseases I've never heard of on dry erase boards with nine of my closest, overzealous friends.
Evidently these medical school folk have this idea in their head that we are supposed to interview human beings and like... figure out what might be ailing them.
Dude. IT'S ABOUT DAMN TIME.
Last night we had one of our preliminary forays into physical diagnosis (PD). And though yes, my outlook on this whole med student thing has mostly turned around and I'm feeling a lot more comfortable with my path in life, what's expected now might be more horrifying than the basic science hell of last year. We were given a checklist of tasks to do that presumably, when done correctly, would give the examiner insight into the patient's health and body. I think all it gave me was fresh waves of insecurity (and a never ending loop of Oliva Newton John's "Let's Get Physical").
The list included listening for lung sounds, pushing on bellies and feeling for pulses, among other things. Things that require you to be all sorts of up in a patient's business. Things that definitely violate any semblance of one's personal bubble. Things that are definitely meant to be kept within the confines of a patient-doctor relationship.
So who did we have to practice on?
That's right. Each other.
Because that's not awkward. It's not like I see my classmates all day every day, and even everywhere when I'm NOT in the classroom since we all live in the same building in the same neighborhood of the same city, or anything. OH WAIT.
I've never been a... touchy person. Growing up my family wasn't a huggie, kissy, snuggly bunch. We were more of a... here, I'll pay for your piano lessons and nag you about practicing to show my love, family unit. Sometimes on special occasions we shook hands. Like when I moved away to college.
So the idea of putting my hands, hands that have no mother loving clue what they're doing, on a stranger almost brings tears to my eyes. I know it's something I'm going to have to come to terms with. I'm going to be a doctor, this will just be something I do. But right now, equipped with a bumbling, ignorant touch, with no more know-how than a hands-y bum off the street, it's extremely uncomfortable.
Perhaps what was even more unsettling than my own hang-ups and the socially unique situation of palpating your neighbor's suprapubic region, was how... small the entire experience made me feel. I feel like I know nothing. I feel like it's going to take me years and years to ever match the confidence our instructors demonstrated.
I probably feel that way because it's the truth. It WILL take a long time filled with lots and lots of practice. That's what's so scary.
As medical students we're used to achievement. We're used to excelling. We're used to putting in effort and seeing results. Impressive results. But for the first time we're starting to actually learn things. Things that aren't readily transmitted through textbook memorization or attentive listening in lecture. We're finally apprenticing a craft, an art that very few of us have any previous acquaintance with. It's new and it's overwhelming and it's way WAYYY outside our realm of familiarity (although I'm sure there are some who will read this and think, "Uhhh, SPEAK FOR YOURSELF. I could hear split S2 sounds before I said my first word, maybe you should reinstitute those google searches...") (We're a charming breed.).
So, like I said, it's horrifying. We're one step closer. It's starting to be real. We're going to be doctors.