Monday, March 26, 2007

And so it ends

The next time I introduce myself to a patient, it will be as "doctor." Today was my last clinical day for the rest of my medical school career. And so Mr. Jefferson, who is in his 20s and just discovered he suffers from narcolepsy and sleep paralysis, will be the last patient to have heard me introduced as "a medical student in here today."

I was trying, on my drive home after my shift, to remember the first patient I saw in the hospital, just for comparison. But I can't remember him well. I do remember he was an elderly gentleman, with heart failure and a body suggesting no immediate danger of starvation, but I can't place his name.

More instructive, perhaps, is to try and remember how I interacted with him. I can recall my checklist, the 3x5 card crammed with obscure questions I generally forgot. And I also recollect that I had not yet learned the physical exam, so my three quarters of an hour in his room was solely to gather his story.

Most of what I've learned has been piecemeal, I think. Starting back in first year with interviews, progressing to the physical exam, learned in parts with a classmate first, then practiced as a whole on patients, trimmed under the influence of surgery attendings and residents mocking the "medical student exam" for its thoroughness to a cursory affair, lengthened during medicine, and focused when my knowledge expanded sufficiently. I remember first year, picking up a copy of the New England Journal of Medicine, forcing myself to read through an article, understanding half the the words at most. Now I can pick up that same article, and at least understand 95% of the words, usually I can follow the concept, and I'm beginning to think how I would apply that article to my own practice.

Though it is still scary to think of calling myself doctor, to think of being a doctor, to make life and death decisions, it is easier, thinking how far I've come.

The next two months are pretty laid back. A month of reading medical history, and a month of "transition to residency" classes. Then graduation, vacation, and the specter of July 1.

16 comments:

Anonymous said...

Congratulations Doctor! I have always been so impressed with how hard y'all work, and know that I would never do it!
An RN, and happy with that!

medstudentitis said...

wow. pretty crazy! No exams before residency? Lucky you. In your position in 2 years I'll be cramming for the LMCC.

Thainamu said...

My congratulations as well! Good for you!

My son had his first day of internal medicine rotation today, after 12 weeks of surgery. His first comment: the internists are a lot nicer to work with!

p.s. Can you provide the full feed for your posts? ;-)

Nathan said...

anon - thanks, and I'm glad you're happy with it. I wouldn't do your job either.

medstudenitis - our exams before getting a license are spread out. The first part we take after our first two years, the second after our third, and the third we take midway through our intern year. So no exams now, but there will be a big one in six months.

thainamu - Of course they're nicer to work with. We get more sleep.

Anonymous said...

My sincere congratulations, Dr. Nathan! I too, second the other RN's sentiments. I wanted to be a doctor at one time but no longer. I still have a bit of a desire to be a PA or ARNP . We shall see whether that will progress. :)

Enjoy your vacation and your reading up on medical history. :)
BTW, what books would you recommend for medical history? I have one such book but it is primarily a children's book to be used alongside a biology or chemistry text. Any suggestions would be appreciated.

~Anonymous RN

Marian said...

Hmm. I don't work in medicine at all, but I have still found your blog fascinating. I know that I just anonymously read your blog, but I can't help but feel elated for you. You get to tack on those elusive suffixes to your name.

Congratulations on a milestone accomplishment.

Tara said...

WHAT!? You are done? WOW! Congratulations. I'll have to switch you from my "med school" folder to my "doctors" folder in my favourites ;) Keep up the great blogging.

medstudentitis said...

Oh and in terms of history of medicine, this is a great book:
History of Medicine: A Scandalously Short Introduction by Jacalyn Duffin

http://www.amazon.com/History-Medicine-Scandalously-Short-Introduction/dp/0802079121/ref=sr_1_2/002-3575650-0924821?ie=UTF8&s=books&qid=1175194071&sr=1-2

Nathan said...

Marian - thanks!

medstudentitis - thanks for the recommendation. My reading will primarily be focused on William Osler (one of your countrymen, though we like to claim him too) and the development of the modern medical ethic.

Nathan said...

tara - no, I'm not quite done. Graduation isn't for another 50 days. But that's mostly formality at this point. Thanks for the encouragement.

Alice said...

Nathan - You have pre-residency classes?! That sounds partly like a really great idea, and partly like a boring way to spend a month. What are they supposed to cover, and how did your school end up having them?

The Angry Medic said...

WOOHOO! Nathan's DONE! My GAWD! Sorry for gushing, but at this point in my sorry sad medstudent existence I really can't see myself graduating. Med school's just like, you know, THE REST OF MY LIFE.

But in 50 days I'll have to update my links and move you from Med Students to Doctor! WOOHOO! Another one survives. Congrats!

Nathan said...

Alice - It is actually just about 3 weeks of class, but I have no idea how it came about. I think, since most people don't do much of anything (*cough*, medical history, vacation, *cough*) after the Match, it is a way to get us all together and send us off without embarassing the school. Though there are probably a few business tips and such thrown in, since we're all eventually going to leave residency. I'm treating it as a way to see my friends before we scatter to the four winds.

Angry Medic - Excitement like that can be catching...thanks. I'm sure you'll graduate sooner than you think. It is amazing for me to look back now and think "wait, this has been four YEARS?!"

The Angry Medic said...

Four years?! FOUR? That's all you guys have to live through? We have SIX!

*long cinematic NOOOOOOOOO...*

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