Learning Medicine is the Easy Part

Growing up, I was the typical kid obsessed with superheroes. Flying, lifting cars, and putting away bad guys are all great, but what I truly found fascinating was their desire to help people. As I grew a bit older, I realized that selflessness is also found outside of movies and comic books. I often think of my dad as the first superhero I ever met. His kind-hearted belief that there is good in everybody allows him to help others and expect nothing in return. To this day, his acts of kindness inspire me to help others. His actions, coupled with his tough yet gentle personality, would have made him a great doctor, had he chosen to become one. Selflessness comes so natural to him. To me, not so much. Having just said that, it might sound like I should not be going into medicine. Indeed, my insecurity about becoming a doctor was, “How do I develop the personality of a doctor?”

Doctors come in all shapes and sizes, but I always saw them as modern day superheroes that walk on water. They are the talented people who have their entire life together—a life composed of struggles, hard work, and the subsequent triumphs that allow them to enjoy life’s greatest rewards. How, then, do I go about transforming from a shy “adult” into somebody responsible for the well-being of others? The answer came to me in bits and pieces during my experiences as a first-year medical student. Exposure to patients and their stories during my clinic site visits have allowed me to reflect on myself as a person and a healer.

At first, I was both excited and nervous about getting to do clinic site visits. Having purchased my first stethoscope (picture above!) and sphygmomanometer (aka blood pressure cuff), I felt ready to start learning how to work with real patients. My expectations might have been skewed by watching too many episodes of Grey’s Anatomy. I expected a much more hands-on experience, so I felt disappointed when my first site visit was more like shadowing. My faculty emphasized that the initial goal was to get acquainted with the clinic and observe the way doctors interact with patients. My physical exam skills were not perfect, but I grew impatient and felt the need to practice what I had learned in my Practice of Medicine course.

In January, I finally got my wish. “Why don’t you go in and talk to them and then you report back to me,” my faculty asked. My jaw must have dropped to the floor. I literally only responded with an excited nod and headed to talk to my very first patient. OLD CARTS (a useful acronym for asking about pain-related complaints) helped me knock it out of the park. I reported to my faculty, talked about possible diagnoses, and completed my site visit. It was, at the time, my favorite day of my first year. I still have the Instagram post to prove how excited I was. I felt so confident and victorious. I had finally gotten a glimpse of what it was like to be a real-life superhero.

Needless to say, I walked into the clinic very confidently during my following site visit. “The confidence is just a side effect of how great I am with patients,” I arrogantly believed. This time, my site visit was the opposite of my January one. I walk into the room, not bothering to jot down some notes or even the OLD CARTS acronym. “Good afternoon, you must be…”. After a long pause, I realized that I did not bother to look up the patient’s name. (A surgeon or emergency doctor is probably rolling their eyes somewhere thinking about how trivial a patient’s name is when you’re saving a life.) I could have just looked up the name or apologized to the patient and asked for their name. It really was no big deal, except it was to me. I always kept the patient in mind during any encounter. I wanted them to feel important, listened to, and comfortable. Not taking the extra second to glance at their name on a screen said much more about how I was beginning to perceive patients.

I had become the medical student I did not like—one who sees patients as if they were written cases we work through in our PBL classes . I went to talk to an uncomfortable, hurting, vulnerable person seeking care and instead saw a chance to show off my clinical skills. I did not see a person in pain but rather a case of clinical symptoms that would merit a “cool” write-up for class. Somewhere along the line, I forgot that these patients are also human. It sounds impossible to forget. I still treated every patient with respect, but at what point did a patient stop being John Doe and start becoming “rash guy”?

This experience taught me that being a doctor and healer is more than knowing every blood vessel in the body. Reading Nolte’s The Human Brain will not teach me how to be humble and compassionate. I cannot observe empathy on histology slides. I learned to look at patients more carefully, not as one would observe the skin for bruises and scars, but by assessing their feelings. Is this patient scared? Do they know why I need to shine a light into their pupils? Does my white coat intimidate them? Do they feel comfortable telling me about their personal history? My goal for future site visits is to develop the personality of a doctor I keep talking about. I want to learn more from patients. What can I as a medical student improve on to come across as confident, knowledgeable, and caring to every patient I meet?

Recently, I had the chance to reconnect with friends and family back home. I am constantly asked about what medical school is like. I know they are expecting stories about jamming straws into peoples’ airways because they were choking in the cafeteria, but I first happily tell them about my site visits. These experiences have allowed me to grow the most as a person and a student. It is interesting to learn about diseases, but it is also extremely rewarding to learn how to relate to people who are in pain, be it physical or emotional.

I also get asked about how difficult it is to study medicine. I often say that learning medicine is the relatively easy part about being in medical school. We have all been students for years. We know how to crack open a book and absorb its information. The knowledge required to be a doctor can be found in many places, but empathy and altruism must be developed by students on their own. Learning about healing and how to connect with others, what I consider the real superpowers, is the difficult part about being a medical student. For now, toward the end of my first year, I do not worry about having to become Superman overnight. I know that the experiences throughout my next three years in medical school will prepare me and shape me into the physician that I want to become.

-Luis

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