A third year student talks about a great attending

As a 3rd year student, you are always scared of getting pimped, being asked questions and not knowing the answer.  When I was in the intensive care unit, I had a great attending who would get the whole team together and then ask every member of the team questions.  He would go around in a circle so that every single person had to answer and by the time you got to the end nobody remembered who was right or wrong.  Then, he would tell the answer without acknowledging that anybody was right or wrong.  When I didn’t know the answer, I would sometimes try to think of something that would help people laugh because you tend to get a little bit downtrodden in the intensive care unit when a lot of patients don’t do very well.  When you are working with a group of people that are happy to be there and are very supportive of each other and can laugh together, it makes the whole thing worthwhile.  This attending made me feel smart.  Even when I said the wrong answer, he made me feel like I had contributed.  It didn’t even feel like work…

 A student writes about OB clinic

The sky was a pristine cold blue, and the temperature made me cross my arms as I walked across the hospital parking lot to the obstetric office for my afternoon in clinic.  It had been thirteen months since my last birth working as a doula, and I was excited to be with pregnant women again.  I was handed my first chart of the day, and my preceptor gave me the one line summary of the patient: “18 year old G1P0 at 35 and 6, no issues, here for her prenatal visit.”  I opened the chart, quickly glanced at the patient’s blood pressure and urine dipstick results, and made a mental note about them being normal as I walked down the hall. 

Stopping at the bright blue clinic door, I knocked gently.  Inside was a small-framed Hispanic woman, with a belly that looked as though it was just as much in control of her balance as she was, seated on the exam table.  She had a short hair cut and one gold tooth in the front of her mouth.  Her boyfriend sat in the chair beside her and looked at the floor.  I washed my hands, introduced myself as a medical student, and sat down on the stool.  “How are things going?” I asked. 

She excitedly showed me where she was feeling kicks and told me that he liked to move every time she lied down.  Then, with hands that look like they move with more experience than they actually possess, I began feeling her melon-shaped belly.  I felt a firm, round mound slightly left of center and followed it down to a point just above her pubic bone, hoping that I would actually be able to tell whether or not a head was there.  I breathed a sigh of relief when, more due to her small frame and less due to my skill, I felt a round hard shape between my thumb and forefinger and confirmed the baby’s vertex presentation.  Then I pulled out the measuring tape and explained that the length of her belly should be close to the gestation age in weeks.  I began to get lost in facts I needed to review later when she interrupted my thoughts with another question:  “So, how big do you think my baby is?”  We launched into a new talk about how big babies usually are and how much they grow, and I was very glad to be able to rely on some of my knowledge from previous childbirth educator training.

Then came the moment of every prenatal exam when I hold my breath.  I felt confident that I should be able to find fetal heart tones on this patient, but I knew that if for some reason I did not find them it would leave these parents-to-be in panic until someone who could find the heartbeat arrived.  I set the lavender probe halfway between the patient’s protruding belly button and her blue jeans and applied more sonogram jelly than I could ever possibly need.  Immediately, a loud heartbeat filled the room.  I let out a quiet breath that I had been unconsciously holding.

As we ended the visit, I returned to the stool so that I could sit and talk to the patient.  Once her questions had been answered to the best of my ability, but not with the precision that she would have liked, I left to find my preceptor.

When I returned to give her the next appointment slip, I again asked if she had any other questions.  She looked at me and with a sincere voice of gratitude said, “You are a great doctor.  Thank you for explaining things to me and answering all of my questions.”  She had no idea how my heart soared when I heard her words.  There was nowhere else I would rather have been at that moment.  She didn’t just think I was kind; she thought I was a good physician.

 A student writes about Anatomy

When I think of a team environment, the first thing that comes to my mind is Anatomy Lab.  All of a sudden you are thrown in with 4 or 5 other students that you have barely met. It is a huge adjustment, and it is a perfect example of what people outside the medical profession simply do not see or do or understand….The bonds I formed with my anatomy group are some of the closest friendships I have had in medical school.  Our strong ties were formed instantly.  It didn’t matter if we had to go through the same thing 8 times just so one person could finally understand it on the 9th try. 

There were certainly days when all we wanted to do was leave the lab, but we always stayed for each other or took a break and came back later to make sure everyone learned the material. 

For most of us, Anatomy lab was the first glimpse of mortality.  One of my friends became teary-eyed as we dissected the fingertips of our cadaver.  This seemed very personal and invasive to her, and I think it was then that she realized how significant what we were doing really was.  I was glad to be there to listen and give her a much needed hug. 

The learning environment was incredible.  You couldn’t go a second without seeing either a TA or a professor, and they were all constantly willing to help.  They would sit down and explain the same things over and over again, and it was completely okay to say “I don’t get it.” There was never any hint of “you should know this.”  I didn’t get a 100% on every oral quiz, but I learned the material, and I never felt rushed or pressured or embarrassed.

Anatomy Lab taught me how absolutely essential it is to make connections with others.  I don’t think we are meant to go through life alone.  I just don’t think that’s what human beings are built for.  It is so easy to get wrapped up in being afraid of what you don’t know or worrying about making mistakes or having the wrong answers.  In anatomy lab you realize that you are not alone and that you are not the only one who doesn’t get something or who needs something explained over and over again.  You also realize what you are good at, and you learn to lean on your strengths.  One of my group members worked very diligently and produced excellent dissections that could have appeared in a textbook while another group member and I hacked away at important structures and basically tried to create nerves and vessels.  We learned to let him complete the intricate dissections on one side of the body, so that we would all have something to study from, while the rest of us tried our best to find structures on the other side.  I learned that I was a pretty good teacher. 

Sometimes our personalities clashed, but when push came to shove, we were a team.  Medicine is not a solo profession.  You work with people over and over again, and the ultimate goal is to help someone else.

 A student writes about a cardiac surgery patient

It was literally the third week of my third year of medical school, and I was on the Cardiac Surgery service.  I finally had my very first patient that I could consider my own.  I was there when he arrived, and I was able to complete his History and Physical.  He was going to have some imaging studies and then a CABG procedure.  I met both he and his wife as I learned about his medications, allergies, past medical conditions, and social history.  The two were an extremely friendly couple. 

The next morning, I was able to scrub in for his operation.  I even held his heart in my hands while the surgeons manipulated his vessels.  I distinctly remember his lungs being perfectly pink, as he had never smoked a day in his life.  I completed his post-op check and rounded on him every morning after his procedure while he remained in the hospital.  I enjoyed meeting him in the hallway during the day and continuing to encourage him and congratulate him on his post-operative progress.

On the Friday after his surgery, I went to say goodbye to the patient and his wife since I knew that they would be discharged over the weekend while I was gone.  I thanked him for letting me be an active part of his care time and allowing me to learn from him.  Both he and his wife said that they were lucky to have had me on their team because I would make a great doctor one day.  His wife even said that I should definitely go into Family Medicine so that I could be her doctor when I finished my training.