Beginning to Learn from Patients

For the past couple months, I've spent thursday afternoons with 3 of my classmates to practice our interviewing skills in elderly homes and hospitals. It strikes me as absolutely amazing that we are allowed to walk into a room and ask a 66 year old woman, who is suffering from her third bout of cancer - who hasn't talked to her family about it and is awaiting a procedure - anything we want. Including why she hasn't told her family, if she is sexually active, the history of the diagnosis, is she worried or afraid?... Why are we granted that?
We are part of the club, we wear our white coat, and in a few years we will have patients of our own who rely on us... As strangers we hear a patient's deepest fears, hopes, desires, worries, we hear things that they keep from most of the world. Then, after walking into that room and sitting down to talk to the patient, we walk out, thank them for their time, and never talk to or see them again. We don't know what will happen to them, and we don't think much about it after leaving the hospital and riding the T back to wherever we are going. Sometimes it feels like we are more concerned with our "patient presentation" that we deliver to the group and resident supervising us. We stress out about our performance, making sure we include all the necessary details - the reason why they are in the hospital, their medical, surgical, familial, and social history. It's truly selfish, that the time we spend with the patient is so very much unbalanced, serving our education, while we have so little to offer. We are granted a luxury unlike anything I've ever experienced in my life.

However, through these experiences we have an amazing learning opportunity: To hear a patient's story. We may never see them again, but we will remember how they felt being on dialysis three times a week, and appreciation of a family member sitting through each 4 hour session they spent plugged into a machine to filter their blood the way their kidneys no longer can. We hear about their life, what matters to them outside the white walls of the hospital, and in these stories sometimes we get a glimpse of some of the issues we are all afraid to bring up... will they ever live a normal life again? Will they live to see this next new year? How are they coping?

I write this sitting on a plane headed to SF for the weekend, to see a few of my closest friends, to get away from the same med school crowd and to change up the pace. The constant studying, lecture, library, apartment, occasionally clinic or hospital, exercise/soccer when I have time, rarely cooking for myself... it's healthy to break that routine. On top of that, YOLO - you only live once. If it matters to you, find a way to make it happen.

What would have become of me in The City

Sitting in grand central I'm waiting to meet up with my friends for the drive back to boston. The second I get off the train I feel the pulse of the city, the way that if you pause you notice the world rushing by you, it's like being a rock in the rapids, it's calming and exciting at the same time. I wonder what life would be like had I chosen to go to nyu. Would I become a different physician, find different hobbies, make as many new friends as I have in boston, would school be more difficult or easier? What would it be like, and what would I be like. I chose tufts for the community, support, faculty and adminstration. I'm happy with my decision, but I will always wonder what would have become of me in the city.
Standing in the middle of the concourse, i hear 3 different languages at the same time. I love it.

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What I see is normal to me...

On the train headed back into the city from a weekend in poughkeepsie to visit my god parents. Along the hudson, the trees are a mix of orange, yellow, red and brown...i understand that this is why so many people love fall and the change of seasons, however I can't appreciate it. I have an x chromosome that limits the wavelengths my cones can pick up on... put another way, matching ties to shirts is a struggle for me, which is why I insist on shopping with women, who have 2 x chromosomes, and rarely are color blind for that reason. After just a few months in med school I have a stronger understanding of our genome, how and why many birth defects occur, and I've effectively become paranoid about my future children being negatively affected by the dna I may or may not know I'm carrying... Thanks genetics!
On my last exam, one of the courses I was tested on was molecular biology. On one of the questions, I was given the description of a virus im not familiar with (but I understand how the general class of virus it belongs to functions), applied concepts i learned, and essentially described how a virus can cause cancer. Yes, thats right, we learned how certain viruses can cause cancer. I imagine 10 years ago med students did not learn this... Meaning that 10 years from now students will be learning things well above what I know now. They say that the majority of the science that you learn in medical school is discovered to be no longer valid, or just completely incorrect 10 years after you graduate. Crazy to think that but also amazing that our collective medical knowledge is developing so quickly.




The girl sitting next to me is on the phone and having a personal conversation, making it tough to focus on what I'm texting, yeah I'm on my cell phone right now, how cool.
Cheers

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Trying something new... first blog from my phone.

If you want to know how soon my next exam is, ask me to tell you today's date.... the further off my response, the closer the exam. This morning i thought it was the 9th. Then I quickly corrected myself and stated that it's the 11th! proud of my amazing memory, even under times of high stress I was impressed by how quickly time has gone by in medical school.... That's when I was told that it in fact is the 16th.... as I write this, I'm on the T (subway) headed to school for another 12+ hour day of studying. Realizing that med school is probably the most time consuming and challenging thing I've ever done, I've decided to try something new. In order to keep up this blog, I'm going to attempt to write shorter and more frequent entries when I have "forced" down time, such as when I'm commuting to and from school, clinic or hospital, which means I'll probably be on the T while doing this. My idea is also an excuse to spend more time using my amazing new phone. It's all touch-screeny, light-weight, super fast and neato. :)

Time to finish up... Next stop, Tufts Medical Center.

You see some crazy stuff in the Emergency Department, and every now and then a good film on a Saturday night...

The T (subway car) smelled like hard alcohol... it was the last one of the night, which meant it was just before 1am, and filled with a lot of people leaving the bars and heading home to skip out on paying for a cab fare. I just got out of seeing the movie "Waiting for Superman," a documentary about our public school system, the impacts of teachers unions, politics, effective teaching, social issues including income levels and neighborhoods surrounding schools... and a lot more... and how this is all affecting the education of kids in our country...

It was very well done, told engaging and powerful stories, and sent many necessary messages, but it was also incredibly frustrating and sad to be reminded that education is not equal in the U.S. Not every student has access to a great education, and the repercussions of that affect all of society. I'm not going to get into the details, I want to go to bed and it's late, so instead I'll say you should definitely see this film.

This movie reminded me of why I'm here in Boston studying more often than not, and spending my weekends in the library... because like education, health care is not equally delivered in this country. Both systems are broken, and I've spent most of my adult life engaged in both of them. During the last couple days in the emergency department I've seen a toe nearly cut off by a chainsaw, metastatic lung cancer so far developed that an untrained eye like myself can immediately see it on an xray, infected hands that require multiple operations to clean out, broken bones, chest pain, heart attacks, head injuries, people without homes who drink so much they arrive unresponsive, and a lot more... This experience is amazing, thrilling to be a part of, and a privilege to learn from, but I wonder, when I become a physician, what will I be doing to change the system, to have a positive effect on the patients who don't have the resources to be treated and don't have the voice to advocate for themselves... Luckily I'm in my first year and have plenty of time to figure it all out (I need to put more worry into passing my exams before I try to save the world), but I'm still not sure how I'll do this.

In the mean time, I'll be mildly upset and frustrated that the Huskies are about to lose to Arizona... not cool.