Aeroflot Russian Airlines
Time to Destination: 00:55/ Latitude: 45° 49’ N/ Longitude: 74° 21’W/ Altitude 10363 m/ Ground Speed 857km/h
In less than an hour, I’ll be landing in JFK Airport in New York. It’s been 34 hours since I left my home for the last 3 years and I’ve had some time to reflect. (Full disclosure: I’ve been watching movies and reading “Unbroken” for most of the journey)
It’s been quite a roller coaster ride. Last August, I nervously walked into internal ward “D” at 7:27am to start taking blood for labs and putting in IV lines (or “opening veins” as the nurses would say). And though we had practiced on each other, it was still nerve wrecking the first time I put in an IV line in a patient. I hid my fear behind my white coat and confidently walked in, introduced myself as a student before putting it in. The patient’s daughter asked me later why my hand was shaking so much.
Later in the rotation, I walked into an empty department one morning. Confused I walked down the corridors wondering where all the staff went. At the end of the hallway was a closed door, which was unusual for the morning. I was shocked when I opened the door. An elderly man with multiple chronic illnesses had had a heart attack. A code was called and the residents were preforming CPR, while the intensivist was trying to intubate. My attending called me over and told me to get in line for compressions. He was the first patient that I saw die. I had chatted with him yesterday morning while I was taking his blood.
I remember my first patient write-up that I spent hours pouring over UpToDate and other medical references. I handed the final product with some pride as I had put in a lot of effort. My attending sat down with me to go over the write-up and lets just say I walked out of that meeting deflated like an atelectasis. And I also remember feeling very incompetent during rounds when I was pimped by the attending, who seemed to expect us to know every little detail. I’ve discovered a plethora of gaps and disconnects in my vast First Aid knowledge base. I’ve learned a lot over the last year but there are still times when I feel inadequately prepared for what is ahead. And I know I will never stop learning.
One time when I was hanging out in the Emergency Department, a plastics resident asked me if I wanted to learn how to suture. I jumped at the opportunity and he took me to the suture room and showed me the different types of knots. He then supervised me as I sutured the lacerated finger of a 17 year-old boy. The father was eyeing me skeptically as I tied the knots, which was unnerving. I’ve had many more opportunities to suture since but that first time will always be the most exciting suture I’ve done.
During ObGyn, I scrubbed in on a Caesarian section. It was beautiful and horrifying all at the same time. After they had pushed the baby out of the uterus, they placed the uterus out of her abdominal cavity and sutured it. I could not believe how much blood there was (Less than 1L is normal for C-sections). I was do not know what I was expecting but it was pretty shocking the first time around. But the smile on the mother holding her baby after she woke up from the surgery was radiant.
There were frustrating moments in Pediatrics when the parents would not consent to simple procedures due to their religious beliefs. And they would try to hide relevant clinical information for fear of their child’s future prospects as a bride or a groom (Haredi Orthodox Jews practice arranged marriage). We learned to work within this cultural context and request the Rabbi to intervene or ask more direct questions to get a clearer history.
It’s hard to believe that the first clinical year is over. There are many little stories like these that I will take with me to my residency as a reminder of my medical school years and my pursuit in becoming a physician. The experiences in and out of the hospital during the last year have been challenging but extremely rewarding. For those of you who are embarking on your clinical years, embrace the difficulties and cherish every moment, as it will be your best year yet.