It began calmly enough. My entrance into the pre-med post-baccalaureate world was a pleasant orientation, a short overview of the curriculum punctuated by an outdoor lunch with professors. Everyone was interested to know what persuaded you to pursue medicine as a profession -- where you’d been, what you’d done, or who you'd met. My class bonded over our shared passion for a life in medicine, but also over our collective uncertainty about how much could change (or how we could change) over the course of the one year program.
I’ve been on this journey just over 3 months. Here’s what it’s taught me so far:
The elusive goal of becoming a doctor and a healer is perpetually pushed further and further away with each lecture that confuses, each study group that falls apart, each exam that doesn’t quite go well. Although I’ve always considered myself to be the grounded sort - the one that remains calm even as confusion and frustration sets in for others - by the end of September I found myself among peers who felt they needed to arrive at the library at dawn on Saturday mornings, and felt guilty leaving before dusk. But even endless hours in the library didn’t seem sufficient, and much like an addiction, studying became a companion to each of my routines: I flipped through histology slides while brushing my teeth; I re-listened to biochemistry lectures on my ipod during my morning commute to school; I stood in line for coffee with my silver mug in one hand and my flashcards in the other.
I’ve learned there is a unique kind of isolation which comes with a medical education. You’re perpetually surrounded by peers, professors and mentors, but the sheer volume of information you’re expected to master (and the little time you’re given to master it) can make you feel like a lone swimmer in a vast ocean, just managing to keep your head above water, yet a little afraid to do even that. Keeping yourself afloat reminds you of what lies ahead -- more water, and no islands (or even rocks) in sight to provide an incentive to keep paddling.
And yet, there are moments when I’m reminded, briefly yet wondrously, that despite all the paddling (and occasional flailing), this is indeed what I most want to do. A case in point has been a didactic course I started only this past month. Rather than delving into the gritty details of fatty acid synthesis or the difference between myxovirus and adenovirus, we discuss the art underlying the practice of medicine: how much can be deduced about a patient’s health by watching them walk into a room, how the most powerful diagnostic tools in an exam room are a physician’s hands. Over group discussions about the complexities of patient histories and formulating differential diagnoses, I keep thinking, “How does this all happen in a matter of 11 minutes (the average amount of time that a physician spends with a patient in Massachusetts)?” I already know the answer: it doesn’t all happen; that there are things that physicians choose to skip over or delay for another appointment, in the interest of time, money and a waiting room full of distinctly impatient patients. The challenge of practicing good medicine – of being a good physician – can easily seem impossible. So, what’s the incentive to try?
At the end of the day, it’s the same incentive that drives me to continue this program – you handle the devastating lows by reminding yourself of the possibility of incredible highs. This lesson came early on during a visit to the administrative office after the first exam of the year. They'd posted the med student averages for exams, the averages that determine the letter grades for students in my program. I had done mediocre at best, and wondered if I had made the right decision by pursuing this program. Was I setting myself up for something I simply could not do? Was there truly a future for me in medicine? Once again, I found myself wondering why I wanted such a life in the first place. As I walked out, I found myself staring at a rack against the wall holding a single short white coat. In the flash of a moment, I watched as a med student dashed out of the stairwell, reached for the coat and slipped it on as he ran down the hallway to the hospital. Yes, there was my reason.