On the Spot
I’m at that rather dubious stage of my medical education wherein friends and family will quite happily tell me about their various health woes in a manner expectant of a sensible answer. Sadly, I can no longer get away with the excuses that served me so well in the first three years of uni (“I haven’t done any clinical medicine yet”) or the more recent version (“I haven’t done that speciality yet”).
I don’t always try to avoid answering, because sometimes I think I can actually be of help. One of my friends had a relative who had been discharged from clinic with a letter explaining the diagnosis. However, because this letter was a letter to the GP in which the relative had been copied in, most of it was gobbledygook to them. The letter was chock full of medical terminology that they found completely undecipherable. It was thus extremely gratifying when I was able to just simply explain what everything meant, being a walking-talking medical dictionary in a way.
Sometimes though, my actual medical opinion is sought, and that’s when I get a little nervous about whether I’ll really be helping or hindering. As a doctor, you are accountable for your advice to patients (diagnosis or management) and what that actually means is becoming more clear. What’s also slightly unnerving is that, quite often, friends and relatives seem to put more weight in your words that those of their own doctor! The mix of someone you trust as a person who also has medical knowledge seems irresistible… For me, it took a while to understand why a friend would put so much faith in what I was saying, and once I realised this, I have tried to ensure that my advice wasn’t going to be a substitute for going to a specialist.
Having said that, I do want to help when asked. I want to be able to give comfort, to point friends and family in the right direction, to be useful. It also is nice to realise that my student loan is not going to waste… I guess what I find difficult is that I don’t feel qualified to give an opinion and so am scared I’m giving the wrong one. But when I’m a doctor, that’s not going to be good enough for my patients. Sure, it’s ok to be scared sometimes, and an element of self-doubt can be healthy, but the only way to gain that confidence, to feel qualified and deserving of patients' faith, is to be the best that I can be. It’s a long hard slog, but ultimately worth it if I know that what I say and do will be the best that I can do for my patients.
"Top 10" Lists
Some of my favorite year-end lists are here:
The Boston Globe's Big Picture Blog’s 3-part 2008 In Photographs series
List-making seems to satisfy a deep-seated need to categorize things, but also the need to show off one's encyclopedic knowledge of some category and taste in judging them (this aspect has been recently parodied by the brilliant David Rees).
It's hard to come up with a meaningful "best-of" list like, say, the ten best moments of medical school. (A list of the ten worst experiences of medical school would be easier, since #10 through #2 would all involve studying for USMLE Step 1, and #1 would be taking it.) It's an interesting exercise, but when I look back on medical school up to this point, lots of moments blur together. The things I remember as the best parts are more vague, like a month where I really liked my team, or a couple of weeks where I really had a good routine going.
But the end of the year demands a list, and who am I to defy tradition? So here are the top ten things I learned this year:
9. The most stressful part of an interview for residency is finding the right conference room within a gargantuan maze-like hospital.
7. Text messages are ridiculously expensive, despite being basically pure profit for carriers, and can inflate your phone bill even if you only receive them.
6. You can see the actual tools used in the Watergate break-in at the Gerald Ford Presidential Museum in Grand Rapids, Michigan.
5. For some reason, NBC has posted dozens (maybe hundreds) of clips from their 1980s game show of preposterous physical competitions, American Gladiators.
4. In Alaska, the practice of flushing wolves out of the bushes with bombs and gunning them down, known as Aerial Wolf Hunting, is considered by some to be a sport. If I were to travel there, I don't think I'd feel OK about participating in this activity. It seems a little unsporting. But you know what they say...WHEN IN NOME...
3. One of the most difficult things about growing up is realizing that Halloween is sometimes just another day; even though it's October 31st, people will schedule things like academic conferences on that day, and you can't wear a costume.
2. When you live in Michigan, Easter can be snowier than Christmas.
1. The fourth year of medical school is terrific, because you have freedom to decide what you're going to learn and opportunities to work closely with residents and attendings, but, since you're a student, you also have some extra time to get to know patients and think about what you want to do with the rest of your life. Or to just watch American Gladiators.