Wrapping it up!!!!

April 30th was my last day of medical school. I still have graduation in front of me, but I have May off. Bitter-sweet is a perfect way to describe my feelings as I finished my presentation on my dissection of the portal system. In fact when I think about it, the very idea of my project has some relationship to the fact that I will be moving on. I chose to research a procedure that is very seldom done in the ED, but for extreme circumstances and/or environments. The procedure is balloon tamponade of esophageal varices. This is a last resort measure when someone comes in with upper gastrointestinal bleeding, whereby you put a tube down someone’s mouth, and there is a balloon attached, which can be blown up to apply pressure to a bleeding esophagus. So I opened with my rationale for picking this topic, and it was along the lines of me being in the Army and being in the middle of nowhere and I get a patient with varices, but no endoscopy suite or fancy vasoconstrictor that is found in any ED. To top off the slow transition into a different stage of my life, all the other presenters had pictures of their kids, dogs, etc at the end of their presentation, so since I went last, I felt compelled to spread the news of our pregnancy, and I told them I was sorry I didn’t have a picture, but even if I did, it would only be about 1/8 of an inch big, so they congratulated me, and I was on my way. I took the next hour to walk around the school and hospital taking pictures of things that were pleasant reminders of the last four years.

One thing that I took a picture of was a statue of a man carrying a really big box, that was obviously weighing him down and making him struggle. So it hit me that the statue was the perfect artistic representation of what being a medical student was like.At the moment, I could relate with the statue’s meaning for me in medical school. Medical school is an ever constant struggle to keep your head above water, while carrying a steel box at the same time. When I entered medical school I had taken at most 16 or 17 hours of college courses in one semester. Most semesters though were 12-14 hours because all the labs associated with a science major. The first semester of med school is close to 21 hours worth of classes. The amount of information is daunting and relentlessly coming at you faster and faster. The worst aspect, is that not only is it a ton of stuff, but I had to read it 2-3 times over again, in order to learn it. And none of it was rocket science, but it took many hours to master the amount of information. 2nd year was a total blur due to the caffeine high I took on. This was more of the same, but instead of being tested on 3-4 weeks of info for 6 classes, we had mid terms and finals, which meant you were responsible for 8-10 weeks of info for 6 classes. And at the end of the 2nd year you took finals over the whole year, not the semester, but the year! And when you were done with a 2 week marathon of finals, you entered an ultra marathon of about 6 weeks to study for Step 1, which was over the first 2 years of all of medical school. And if you survived that, you could look at this statue, and know, just exactly what is meant by the image of a man who can’t even see over the steel box that he is holding up, and much less, trying to move forward at the same time. Then I walked over and read the plaque, and it was a statue dedicated to one of the physicians at the school, and the name of the statue was “A Good Physician”. It didn’t take too long for me to instantly identify and relate to the message that was constructed with steel and concrete.

So for the next couple minutes I took a moment to think about what being a good physician means. Plainly, by the general nature of the statue, a good physician is someone who can carry a load. But what is he carrying? I would say compassion, determination and responsibility, to name a few. Responsibility comes in many ways, including multiple patients to care for at once, having multiple options for treatment and patient care to decipher through, or even the constant nature of learning and reading as technology and science advances to better patient outcomes. The second factor I mentioned was determination. This is an ever bearing factor when you work in the medical field. Depending on the specialty we choose, will make this factor weigh more or less. If you choose to work in the ICU or on the medicine ward, it is not uncommon for patients to be less healthy and vigorous than they were before coming to the hospital. So the ability to get up every day and be positive about the reality of taking someone whose heart was functioning at 85% before their heart attack, and after their stay they are discharged at 65%, can be difficult to deal with on a weekly, and sometimes daily basis. But nonetheless, it is what we do.