Classroom to clinic
Just check in with the patient and let me know how she did overnight, my resident instructed me. A straightforward task, I thought, but still, nothing comes easy the first days on the hospital wards as a third-year student. I peered into the room and saw my patient cradled in her mother's arms. An 11-month-old who recently arrived from Guam, she had a raging ear infection. Her mother looked weary from the long nights. What could I offer? More immediately, where to begin?
"Hi, I'm Rachel," I said tentatively, armed with my clipboard and stethoscope, my new white coat stuffed with review books. I had that annoying little quaver in my voice that I wish would disappear. "I'll be the medical student helping to take care of your child."
Third year of medical school means leaving the cozy nest of the classroom, where the professors treat you royally and where you have 140 fast friends the day you step in the door. I never would have predicted saying this, but going to lectures and taking tests are a comfortable life. Sure there's stress, but it's manageable. If you are late, the worst you get is a fleeting frown from the instructor. Now, being late is not just disrespect but a sign of real dysfunction.
Expectations on the wards are certainly higher. No longer are professors taking care of us, checking in on our feelings, and helping us reflect on the process of becoming physicians. In a sense, we have been spoiled. Now we are the ones taking care of others. How could I, with literally two years of medicine under my belt, take care of anyone else?
In the three days before we hit the wards, we stuck each other with needles to learn how to draw blood. I appreciated the exercise, not only for the technical skills but for the visceral reminder of what our patients go through regularly. A hematoma--a localized collection of blood--gathered underneath the skin of my wrist where my classmate had practiced. It throbbed for days.
Feeling dumb. Equally important, we had psychological prep: a phalanx of professors telling us what to expect during third year. "You'll probably feel dumb at times," one said. "But your job is not to sound as dumb as him, " referring to a PowerPoint image of President Bush (we are in San Francisco after all). Another reminded us of Eleanor Roosevelt's wisdom: "No one can make you feel inferior without your consent." I liked that bit of advice. My mother--also named Eleanor--has that quote hanging at her desk at home. She has repeated the mantra to me and my sister since we were little. Why wouldn't it work now?
I am glad that our superiors warned us of the wave of self-doubt to come. I did feel embarrassed in front of the other medical students when a resident put me on the spot to calculate how much IV fluid to give a newborn based on the infant's weight. I froze and simply forgot how to do basic algebra. I also felt small at times, as medical students are always the last to enter the room and the last to leave, trailing the team of doctors like puppy dogs.
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