Monday, December 12, 2005

A Change of Scene

Psychiatry is over for now, and probably for good, unless I failed the shelf exam. Next up is a week of "intersession" which, aside from being a great excuse for the faculty to take away a week of our Christmas break, will let us "integrate our experiences" and "pool our knowledge" and host of other meaningless catchphrases. What will really happen is that from 8 to 3 we'll feel imprisoned, pass notes, catch up with friends, gripe about the "intersession", exaggerate the hard parts of our rotations, expound on the funny parts, and generally do what a group of fairly well-acquainted individuals do when thrown back together. Think high school after summer vacation.

Actually most of medical school is like high school. Maybe life in general is, but I'm not there yet. Everybody knows everybody else, everybody dates (and sometimes marries) each other, etc. The big difference is that most of us were the nerdy kids in high school, so while there may seem to be a "cool kid" set here, it is a definition of that word which would appear alien to any given ninth grader.

Med school flips one's entire perception of the world around. Suddenly embarrassing topics are normal, and normal topics are slightly disconcerting. It becomes difficult to remember what is appropriate dinnertime or even social conversation. Probably that's to be expected when we are taught (among other things) to frankly discuss the sex lives of total strangers. It bothered me at first, the loss of innocence. Performing a pelvic exam on a stranger the first time was quite uncomfortable, but I think it is worse when it isn't uncomfortable. What has changed within when I can do these exams as easily as I listen to a heartbeat, and discuss even the more deviant types of sexual activity without blushing? My convictions remain, and a part of me judges an interview as a confession. But thankfully (though strangely) there is nothing arousing about a gynecological exam. The "professionalism" training I laughed through last year actually helps.

Physicians cling to a sense of professionalism, because it is that which keeps them sane. Without the strong sense of purpose, the higher calling behind the actions, all that we do would be crass. Even the denial of self, the "ascetic in a sensual world" attitude which must be maintained would be unjustifiable without purpose. Monks are respected but the bachelor or spinster has bittersweet connotation to their denotation. Physicians must go between the two worlds on a regular basis, and that ability to switch from participant in life to observer of it is professionalism. At least part of it. But that's all I feel like exploring tonight.

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