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.  

Wonder and other things

I had these moments during first year where I’d be walking down the street in my city thinking about nerves (I’m a med student, ok? I nerd out more than the average person).  Then I’d think about the person I was dating, or my friends, or something else fun and realize that everything we are and feel and do is simply due to ion concentrations and electricity and chemical gradients, receptors, genes, proteins, pathways… and then I’d have a little mind explosion, “OMG that is SO AMAZING!” How beautiful and poetic is it that love equals ion gradients in my brain!  I wasn’t simplifying love or anything else, but I would appreciate the very small in the very complex.

I don’t really have those moments anymore. Or I haven’t for a while. My brain has been too busy with class, studying, othermedschoolnecessities, bills, errands, relationships, eating, fillingbasicneeds and passingexams.

Except, recently, I did have a moment like that – about blood. Holycrap, it works! Your blood carries necessary molecules to your tissues and remains fluid in your arteries and veins. You don’t bleed all over when you get a cut* and your blood doesn’t become a solid mass and cause you to become blue and dead**. That’s amazing! Of course, there are plenty of things that can go wrong and I get to learn all about that fun stuff, but for the most part – it works! It has worked as long as we’ve⁺ had circulatory systems.  Holywow.

Ok, nerdoutexcitement over. Back to the library. 

*Unless you have a bleeding disorder

**Unless you have a coagulopathy

⁺We as in our evolutionary ancestors

You should go to the doctor

I identified so strongly with her, which is odd because I don’t have a chronic illness.  It was amazing that a fellow med student would get up there, in front of all of us (in our white coats), and tell us about being a patient. Doctors are not good at being patients. Neither are med students. We are not so good at taking care of ourselves.  Just look here, here, and here.  These example focus mostly on mental health*, but there are plenty of examples of doctors as terrible patients with other diseases like cancer, heart disease, and diabetes.

The class was clearly more interested in asking about this patient/student’s (PS) experience than other patients we’d seen. 

“Has your [illness] affected your career path at all?”

“Um, well I’m going into [a specialty that deals with this illness]”

“When you become a [specialist], do you think you’ll just be your own doctor?”

 The professor cut in here and said sternly, “You should never be your own doctor,” and PS agreed. The student who had asked retorted, “Yeah, but how realistic is that?”

We could taste it – the distain for being a patient. We could feel the desire to control and manage our own disease – imagining ourselves up there.

We also wanted to know how she managed rotations and her chronic illness. Turns out she didn’t control it as well as she would have if she were not in medical school with long days. Wow – what a healthy environment.

PS admitted she didn’t go for her yearly visits to certain specialists, claiming that since she’s had her illness for so long, she knew when something changed. But she’d also admitted that her prodrome to medical crises diminished over the years. And how many of us haven’t noticed subtle changes in our bodies right away?

So why did I identify with her? I could imagine myself up there, saying the same things, ignoring the same guidelines I would use to treat patients.  How many times have I already told my friends, “go to the doctor, go to the doctor” (after asking them a bunch of questions, of course), while putting off my own appointments?  Part of it is that managing anything other than school has gotten increasingly difficult. This includes bills, laundry, doctors’ appointments, cooking food, maintaining friendships**, etc. Another part of it is a refusal to be sick. I don’t have time to be sick (who does, why I am any different?). Another part is that barrier that’s gone up between us (medical professionals) and them (patients). This barrier is necessary in order to do our jobs effectively. It’s a fine line, however. Make that barrier too high and you’ll forget the “them” on the other side are human beings with complex lives, not just complex chemical processes. Don’t build that barrier and you’ll bleed too much for each and every patient and you’ll burn out. 

Also – I know how easily errors can happen, I know how scary hospitals really are. I. Never. Want. To. Be. A. Patient.

*mental health is another topic, and I’m luckily fairily happy as far as med students go.

**I’m pretty good at this, I work hard to take the time to foster my relationships