Exiting the Honeymoon Phase

During orientation, they warned us that our smiles would only last 2 weeks before reality sets in and the novelty of being in med school wears off. I've noticed it; the walls that people built during orientation are slowly coming down and people are starting to open up about the stress and about themselves.

Although for me the novelty has not worn off yet, the realities of the hardships and challenges of practicing medicine are slowly creeping in. Hearing horror stories from upper years about losing patients,  the stress of feeling powerless when working with patients in unimaginably difficult social conditions, and the challenge of working in a culture rampant with overworked staff leading to frequent and preventable medical errors. I've already encountered some of these themes in the few patients I've seen and hearing their stories can be pretty heartbreaking.

We all come in wide eyed and hopeful that we can make a difference on both an individual level with our patients and at a systemic level, but the system is incredibly complex, fragile, and constantly evolving. And people can easily fall through the cracks, and they do. Like a mountain in the horizon, as we get closer to it, the steeper, taller, rockier, and more daunting it becomes. The closer we get to providing autonomous front line care, the more the barriers and unfortunate realities of an imperfect system show themselves.

But this is what we chose. This is the career path we chose, and the noble goal of healing and promoting health is unfortunately closely intertwined with systemic barriers and emotionally difficult subject matter. And although I'm still a long way off from caring for patients, I have a greater appreciation of the Everest waiting for me two years from now, and I so far I still want to climb.

The First 2 Weeks and Seeing Patients

Well everything they warned us about the volume was accurate, there is a lot to do! But it is all interesting and a lot of it is review for me given my background so that helps. Naturally, I'm already behind because I was sick the first week and am still figuring out my organization system, but I'm confident I will catch up (at least I keep telling myself that haha).

I had my first day in the clinic with patients earlier this week (yay for early clinical exposure) and what an eye-opening experience it was! I saw 4 patients and was privileged enough to observe two vaginal exams (one on a woman in her 80's, and the other in her 20's who had an IUD removed). I did not expect to feel as uncomfortable as I did during these exams, yet it felt so surreal and like an invasion of privacy to spend 5 minutes briefly chatting with a stranger and the next minute to be staring into their cervix. There will certainly be an adjustment period of getting used to the intimate and vulnerable nature of these interactions. Thankfully, the patients were all incredibly friendly and patient with me. One patient came in with thyroid cancer that seemed to have spread to the lymph nodes and the patient kindly let me palpate the area a few times as my preceptor explained all the different things I was feeling.

I think the worst part of the whole experience was that my hands were either always cold (I was stuck sitting under the AC) or always sweaty; I think it made interactions with the patients more uncomfortable for me. All in all though, it was a really great experience and I look forward to learning more. I think the most interesting part was seeing how every patient has a story; they have unique thoughts, concerns, views on health, and health goals. And the true art of medicine was watching my preceptor tailor the treatment regimens to best fit with all the aforementioned components of a patient's story.