First Tough Patient Experience

I've started to see more and more complex and interesting cases in the clinic as the days go by, and already I feel my moral compass being tested. You never really know how you would handle a situation until you are faced with it, because until you are faced with it, it wouldn't even occur to you that it could even happen. I feel like there is this part of me that goes into autopilot when I  have to make quick decisions. Obviously, these decisions are not about anything important at this point in time as a first year student, but I'm learning to trust myself and follow my initial gut feeling to wherever it leads me. It's as though I am equipped with this invisible meter that that whenever I'm faced with a situation, I go through all the options in my head at light speed, and the arrow immediately tips to "yes" or to "no". No hesitation, no looking back. Later on I reflect on how I handled things and am often happy. However, there are times I realize "whoops, shouldn't have done that, this would have been better", and feedback from my preceptor validates these thoughts. Either way, I'm definitely learning things about myself and where I stand on certain issues.

Once again, I cannot reiterate how amazing it is that we are all walking around without too many problems. But when things go wrong, boy do they go wrong. While alone with the patient suffering from a slew of illnesses, (the doctor went to find a nurse to  draw blood) I tried to talk about cheerful subjects like grand children to take their mind off the situation. Happy at first to talk about the subject, the patient suddenly expressed sadness in not being able to watch them grow up. Completely caught off guard, all that came out of my mouth was "aww". The patient looked at me sternly, repeated the initial statement, and explained how fed up they were with feeling sick and that they could pass away at any moment.

 At this point I had no idea what to say. I just let the words linger, both of us alone in silence. Sometimes you just have to let the silence happen and appreciate the moment for what it is. A moment. A moment of complete vulnerability. A moment of fear. A moment of life. A moment that shook me, but at the same time, I got to be apart of it and for that I am thankful (and the patient seemed to be grateful too). 

Just Breathe

I have successfully completed the first month of med school and I have definitely felt the volume and complexity of the work increase now that I am further in. Needless to say, the most notable experience of October so far was the cadaver dissection, which has triggered many thoughts and emotions that I will describe below, sorry for the longer than usual entry! I have some feels to get out. (WARNING: some descriptive content about death and internal organs - if very squeamish, skip ahead to closing thoughts).

Anatomy Lab 1
Cadaver dissection is truly a surreal experience. There is something haunting about walking into a chilled, large room only to see about 50-100 body bags on sterile metal tables, with metal buckets resting at the body's feet. As you walk through the lab, adorned in white coats, goggles and gloves, the smell of formaldehyde stings your nostrils and clings to you like unruly shower curtains until you almost forget what fresh air smells like.

Like inching your way to the edge of a diving board, I took baby steps to performing the dissection because deep down I was really nervous about it. I've never been good with knives or cutting things but I guess everyone has to start somewhere. When my partners and I approached the cadaver, we took our time to desensitize. First we touched the legs through the bag, then we slowly unzipped the body bag to reveal only the chest and abdomen. Next, we gently touched the chest and abdomen, feeling the oddly leathery and wrinkly texture of the person's skin until we were finally ready to make the first incision. Once we had opened up the skin of the thoracic cavity, I found it easier to detach myself from the fact that this was once a person with a life, a family, and a story of their own. I couldn't detach completely and was caught in this weird dichotomy of enjoying the surgical tasks while simultaneously thinking about the person whom I was cutting into.

The more human side of me felt compelled to talk to the body and explain what I was doing. And under no circumstance did I feel like it was right to leave the body alone so exposed and vulnerable. And when we put it away, I said thank you for donating your body so I could learn. One day I want to look at the face, but I'm not ready for that yet.

Anatomy Lab #2
Despite my best efforts to feel less "attached" to the body, all my hard work was countered when the preceptors revealed the cause of death for all the bodies in the lab. Another piece of the story that was interesting to hear but just made it harder for me to focus. I couldn't help but wonder how did the family react to this? Was the person conscious in their last moments? I tried to push those thoughts far out of my mind before I got back into dissection mode.

This second time unzipping the bag I was greeted by the familiar freckles, wrinkles and beauty marks on the body. This lab we were to remove the lungs which took a surprising amount of pulling. I can proudly say that I held a lung and did not accidentally drop it on the floor like I worried I would. It was a lot heavier than I expected and kind of squishy (however the texture and weight was most definitely altered by the preservatives). I was able to go to another table and palpate a tumor in the lung of someone who died of lung cancer (the tumor felt way more leathery and more firm than healthy lung tissue). I felt so privileged to have these experiences and grateful that someone donated their body to allow for this.

Closing Thoughts
Even though the workload is heavier I find myself managing, and most importantly, not neglecting my health, my friends, and surprisingly my houseplants. Having the privilege to learn and see the inside of the human body makes me appreciate even more how incredible it is we are all walking around without too many issues. I'm not particularly religious but it's hard not to think about the possibility of intelligent design when you appreciate how beautifully crafted we are.

In terms of the med people, I'm starting to narrow in on a few individuals and groups of people I feel like I fit in with, but I definitely still float around not quite sure where I stand. I feel like the awkward new kid in high school in your stereotypical coming of age movie trying to figure out where to sit at lunch. I'm just happy for now to have a few people where I can be my weird self.There have definitely been some people whose bragging and comments when I said I had trouble with something definitely didn't make me feel smart or good about myself, but I try to ignore it. Even though I'm not the brightest in this class, the more I go on, the more I feel my self doubt fading. I definitely deserve to be here and fully intend to stay. Just breathe, and never forget to wash your hands because eventually things always make it through the gloves.