Life measured by exams

The whole year slipped by in 3 and 4 week increments.  Every exam a final, squeezing in life between studying.

I’ve been MIA since kidneys kicked my ass (I’m still really impressed that they actually work).  I’m studying for step 1 now, so I don’t expect to post until later this summer.

My friend just had a baby a few weeks before she was due, a good reminder that life doesn’t stop just because we make a perfect schedule.  Another friend had to put her cat down right before our last exam. We schedule. We study. We’re type A people. But we can’t put life on hold for anything. The most important thing isn’t my score on step 1.  The most important thing is to measure life by the people we share it with.  

Lub dub

Lub-dub. Lub-dub. S1/S2. Systole-diastole. Blood to the body, blood to the ventricles. Lub-dub. Keep it beating. That’s our job. That’s my job. This mechanical organ, this pump made of flesh, keep it going.

Spindle shaped extravasated red blood cells is pathognomonic of Karposi’s Sarcoma.  Will that factoid help me treat patients any better? I can recognize KS without knowing that. Sure, it’s interesting. But how will it benefit my patient? I need to know how to treat my patient in body and mind.  Focus on the drugs. What do they do? What are their side effects? What will be the barriers to having patients take them? What is the best one to give? Tell me that. Test me on that. Tables, tables, more tables. A picture of one person’s dead heart. How will this help me? Tables help me memorize important information. CHF, HTN, AE, d/o, LVH, LBBB, AMI, I’m learning the language. That doesn’t help me help patients. Not yet. It’s like being able to read Hebrew and follow along in the prayer books, but not knowing what I’m reading save for a few words. 

What kind of doctor will I be? Is it at all reflected in the test scores I achieve my first 2 years? I have to learn something. I have to learn a lot. Does doing average on these exams mean I won’t know enough? Does above average mean being a better doctor? What about below average? What if I fail one? Or two? Will I put patients in danger? Or will I, in reality, have a chance to learn it better, in clinic, in a setting where I can see the people I’m helping? I know I will be a good doctor in terms of talking to people, caring about them, and that matters a lot… like alotalot. I just hope I can get enough knowledge into my head so I don’t kill anyone. 

3rd year

So I went to a real hospital for the first time, as a med student. I saw a real patient. I think I’m going to love 3^rd year.  That endorphin release you get when answering a question right is pretty nice. It made me think of the clients I used to work with – the recovering addicts. No wonder they found outdoor movies and spa night so uninteresting; they obliterated their reward pathway (nucleus accumbens!) by overloading it with drug-induced endorphin release.  It made me grateful for the simple endorphin rushes in life. 

So getting questions right feels good. I totally can answer questions confidently, whether or not I have any idea, which the attending seem to appreciate. I can organize data into a coherent presentation. I learn quickly, so the individual variation on what attending prefer will not be much issue.  I actually think I’ve learned something in the past year and a half, so all those things combined will make me a good 3^rd student (I hope).  I really loved the interaction with our preceptor. I forgot how much personalities play into the experience of the healthcare provider. Working at that top-notch hospital before medical school gave me a little window into that. I observed mostly, but I also noticed that the politics and play of personalities.  So much of 3^rd year, it seems, is how personalities fit together. Some students will think their resident is a jerk, and some will like the same person.  It’s not necessarily a good thing, but it’s something I can be good at.

It’s nice to have some decreased anxiety about going to the floors next year. There’s just that pesky step 1 between now and then.