Medschool: Week 3

I haven’t had internet in my apartment since I moved in a month ago, mostly because this illustrious internet company has managed to drop the ball in ways I can’t even begin to explain.  (The company’s name rhymes with “verizon”)… So, I’ve reverted to stealing ambient wireless signals in my apartment.

Anyhow, quick update; Started medical school proper on August 11th, walked into anatomy lab with sharp objects, and they essentially told us to just “have at it”.  In the course of 13 days of lab we’ve completed, in ridiculous detail, the vertebral column, spine, posterior triangle of the neck, back, upper limb, arm, forearm, hand, hip, thigh, leg, foot, thorax, and heart with all the accompanying neurovascular relations and common clinical occurrences respective to each of the said areas. Oh… and they threw embryology on top for good measure.  First test is Friday, August 29th.  Thats the day after tomorrow.  So what did I do after school today? I napped.

Here’s for something a bit more interesting.  Last Tuesday I met with my first patient at Temple University Hospital.  The day before, we had a lecture on Narrative Medicine in our “Doctoring” course, which took me by surprise seeing as they took a liberal arts approach to a clinical course.  After our first patient experience we had to reflect and write…

Waiting on the elevator to the 7^th floor, I started to think about this actual assignment. For my “Doctoring” course I’m supposed to go into a patient’s room and get to know him or her in a way that, I’m guessing, medical professionals don’t usually get to know him/her. We are doctors-in-training who are supposed to go in and not act like the stereotypical doctor. We are to ask for the details of no clinical relevance, to have a conversation outside of the abrasive medical truths that appropriate one as a “patient”, and perhaps, to get a bit personal. Maybe the initial, somewhat intrusive nature of a stranger at the foot of your bed is of the common clinical practice, but I appreciate the fact that this may be one of the final remnants of a relationship with a pure stranger that is not mediated by a patient chart.

And so I start sweating. I’m at the bottom of the medical totem pole, if it even goes down that far, in limbo between non-doctor and doctor. Not identified with the former, and lacking the professional air of the latter. I have no white coat, like I’m going to war without Kevlar, identifiable only by my TUID which I wear like a hospital ID forgery. Any anchor I have to credibility walked right out the door the moment she dropped us off in Mr. H.’s room. No, this isn’t awkward.

Mr. H. must have seen this. Even with acute pneumonia, he lay there, his right hand cupped behind his head, legs crossed, talking with his left hand. Smiling. Of course one of us rattled off, “How are you feeling today?” like an age old bad habit. Like when your nerves do all the talking on your very first date. He smiled again.

Retired now, Mr. H. lived right off Erie for most of his life. He lives alone, and worked at a furniture store moving and shipping pieces he’ll probably never be able to afford himself. I apologize. I’m not doing him justice. “An expensive furniture store, a big company.” At first shot it sounds trivial, however, his eyes lit up a bit, chest expanded, and chin raised when he said it. Even at one of his most vulnerable moments, when three medical students are doing some directed probing, lost in their own thoughts, Mr. H. was proud to share what he had done with his life. To explain what he did. To just talk.

For the next 10 minutes none of us could get a word in edge-wise. I quickly realized I needed to get out of my own head and just listen. Shut up, and listen. His left hand, scorched by life of manual labor, each crack and tributary a different story, waved in concert with his words.

…

As he rounded out his story I asked him, “What would you advise us to do?”. Words always sound clumsy when speaking and swallowing at the same time. He told me that every time he’d been to the hospital he’s had good doctors that put him “back together”. He said, “You need to keep doin’ what you’re doin’, and keep goin, ‘cuz you need to put people like me back together so we can go on and live our lives.” A simple maxim it was, almost understated, and easily lost in the blue-streaked confusion of anatomy lab. It’s something that no one will tell you explicitly, nevermind as personally, in a pure academic setting. Nor should it be. Simplicity as such should only be colloquial, never to be stripped of its tone, its meaning, and set into a powerpoint.

Again, another smile.