{"id":1040,"date":"2019-03-31T18:03:06","date_gmt":"2019-03-31T08:03:06","guid":{"rendered":"https:\/\/thejugular.org\/?p=1040"},"modified":"2019-03-31T18:03:06","modified_gmt":"2019-03-31T08:03:06","slug":"tales-of-a-third-year-nothing","status":"publish","type":"post","link":"https:\/\/jugular.org.au\/index.php\/2019\/03\/31\/tales-of-a-third-year-nothing\/","title":{"rendered":"Tales of a Third-Year Nothing"},"content":{"rendered":"
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\n \t<\/i> Read Time:<\/span>8 Minute, 45 Second <\/div>\n\n <\/div>\n

by JUMAANA ABDU (edited by ROSEMARY KIRK)<\/p>\n\n\n\n

Following are some highs and lows from my first few weeks as a third-year medical student. Medicine really does grant us the privilege of a most unique and intimate insight into human pain, crisis and \u2013 sometimes \u2013 hilarity. All patient ages have been changed, the dates hidden, and most of the details altered so as to preserve patient anonymity. <\/em>
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Entry 1<\/strong><\/p>\n\n\n\n

My first day at hospital, sitting in on ward conference, they discuss a relatively young woman who\u2019s had a paraneoplastic stroke. She has to be taken off chemotherapy due to coagulative complications. The stroke affected her cognitively and her chances of being cured by radiation are <10%. The room is suddenly very solemn compared to the banter of a few minutes prior. Eventually, the registrar says, \u201cSo, I suppose the question is, are we proceeding with curative or palliative aims?\u201d \u201cPalliative,\u201d says the consultant after beat.
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Entry 2<\/strong><\/p>\n\n\n\n

I enter a department meeting late and there are no chairs. An old portly male doctor smiles and pats his lap for me to come sit.
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Entry 3<\/strong><\/p>\n\n\n\n

In clinic, I meet a young, rural father who\u2019s had his left arm amputated secondary to infective endocarditis. Talking about phantom pain he says, \u201cIf I close my eyes, I still have my whole left arm and hand. Sometimes, it feels like it\u2019s being crushed under a brick. It\u2019s excruciating and it\u2019s imaginary.\u201d He is left-handed and an electrician.
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Entry 4<\/strong><\/p>\n\n\n\n

The son of a patient who has been on our ward for a number of weeks gifts the doctors with chocolates. He also gives the intern and registrar a small copy of \u201cThe Essential Jesus\u201d. Curiously, he does not give one to the lovely consultant, though she is standing right there. Is this a compliment (You already have Jesus<\/em>), or an insult (Girl, it\u2019s too late for you<\/em>)?
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Entry 5<\/strong><\/p>\n\n\n\n

Looking for patients to examine, I meet Dr Google, a man with primary progressive MS. \u201cWhy would our immune system<\/em> attack itself?<\/em>\u201d he asks me. He believes MS is caused by bacteria. According to a French study from the 1920s, a doctor cured 23 patients with supposed \u2018MS\u2019 by treating them for Chlamydia. I don\u2019t know how to explain that, unlike with most things, the age of a research paper doesn\u2019t necessarily make it more valuable or authentic. \u201cDo you just believe everything they teach you at uni?\u201d he asks me. Well, um, yeah. But I don\u2019t say that. I tell him that critical analysis is an important part of medicine, but I am glad that he is allowing conventional treatment in the meantime. Science, ironically, relies on faith. Not everyone can individually run every single trial ever so they can \u201csee it for themselves\u201d. Anyway, this man\u2019s MS is severe, his wife passed away a decade ago after years of battling cancer, and his brother died from cancer a few years after that. Concerned, I ask about his mood. It seems his stubborn determination translates vibrantly into his wellbeing. \u201cI don\u2019t see any point in being negative! I\u2019ll look after myself as long as I can, I\u2019ll eat out, I\u2019ll see friends. Misery loves company. But who wants to live miserably?\u201d Despite our disagreements, I like him a lot.
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Entry 6<\/strong><\/p>\n\n\n\n

I notice a trend of sick married men who have no idea what is going on and don\u2019t care because their helicopter devotee spouse is thanklessly commandeering their ship through the maelstrom of ill-health. One woman says to her newly-debilitated husband, \u201cIt\u2019s ok, I know you would\u2019ve done the same for me.\u201d \u201cNo, I wouldn\u2019t!\u201d he says earnestly. \u201cI\u2019d have stayed home with the kids and left you to your parents.\u201d She looks down at her hands and smiles uncomfortably.
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Entry 7<\/strong><\/p>\n\n\n\n

A patient is admitted to our ward after having been found lying on his apartment floor by his roommate, who had returned from a month overseas. He had ostensibly been lying there for weeks. His kidneys are acutely injured from dehydration, and he has pressure ulcerations all over his body. This makes me very sad. Later that day, we see a different patient who is well into his 70s. The records claim he has a son still in high school. The doctors have a bit of a giggle.
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Entry 8<\/strong><\/p>\n\n\n\n

A 90+ woman on our ward had another stroke overnight. Her son is there during our morning ward round and is brushing her hair back absentmindedly as she lies asleep and shuddering in her bed. He is old himself. He says he knows what her wishes are. She\u2019d want to \u2018sleep and not wake up\u2019. \u201cShe\u2019s a strong woman,\u201d he says. \u201cBut she must hate to be like this.\u201d The consultant is an amazingly compassionate woman. \u201cI understand,\u201d she says. \u201cI know what I would want if it were my mum.\u201d A mother never stops being your mother even when you\u2019re 70. She is always this imposing formidable figure of unequalled reverence in your life, even when she is a frail little figure moaning softly under some blankets in a dim corner of the room. I call my mum as soon as I leave the ward.
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Entry 9<\/strong><\/p>\n\n\n\n

In theatre, the surgeon chucks me some bone cement. \u201cGood catch!\u201d everyone sings in chorus. I feel like a superhero. The bone cement heats up considerably in my hands, and I am worried it will burn through my gloves. Later, I text my friends, \u201cThe surgeon chucked me some bone cement today. It was so hot!\u201d They proceed to screenshot this and circulate it out of context, making all the lewd misinterpretations friends can so dependably be relied upon to make.
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Entry 10<\/strong><\/p>\n\n\n\n

I meet my first scary registrar. Maybe it\u2019s just his resting face or my nerves. When he realises he has been grilling me, he makes a joke: \u201cLearn to introduce yourself better, that\u2019s something you can reflect upon in your portfolio.\u201d I agree, feeling like an idiot. He laughs unexpectedly. \u201cI\u2019m joking! Portfolios are bullsh*t.\u201d It takes me a second but I manage to give a conciliatory laugh. The next day though, I still feel like a nuisance because when I show up at the clinic, he just looks at me and says: \u201cOh. You\u2019re back.\u201d
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Entry 11<\/strong><\/p>\n\n\n\n

I meet my first scary consultant. Aforementioned registrar seeming friendlier by the second.
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Entry 12<\/strong><\/p>\n\n\n\n

On ward rounds, we see the cutest old man I have ever laid eyes on. He is Japanese, well into his 90s, and has a wonderfully toothless grin.  We speak to him using a translator. Asking about ADLs, the consultant says, \u201cWho cooks at home?\u201d His wife. \u201cAnd the groceries?\u201d Wife. \u201cTidying?\u201d Wife. \u201cGetting the paper? Going to the shops? Your clothes? Cleaning the bathroom? Taking out the trash?\u201d All wife. \u201cHow old is she?\u201d Eighty-six!<\/em> The old man is grinning along with every other momentously impressed man in the room who is no doubt reminiscing about days gone by when women weren\u2019t so goddamn insistent about having an actual life beyond popping out babies and being at their husbands\u2019 every beck and call. The consultant just laughs and says, \u201cOh sh*t!\u201d The old man doesn\u2019t need a translation to find this funny.
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Entry 13<\/strong><\/p>\n\n\n\n

I am having commitment issues regarding my ILP supervisor for next year. The guy I picked meets every criterion, he\u2019s so lovely, and everyone highly recommends him. But what if I\u2019m rushing, what if I should\u2019ve gone with someone in O&G instead of paediatrics, what if there\u2019s someone better out there? (I realise it\u2019s a mercy that I don\u2019t date).
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I go to an info night. A sprightly young female doctor begins her presentation by raving about how much she loves O&G. I start to regret my decision to go with the paediatrics supervisor. The O&G is vibrant and sweet and beautiful. Suddenly, when asked about work-life balance, her face changes and she takes a step back like a bull preparing to charge. \u201cLook, in O&G, everyone is either divorced or having an affair.\u201d * EVERYONE IS EITHER DIVORCED OR HAVING AN AFFAIR. My jaw drops, along with every other jaw in the room. Then the paediatrics speaker comes up and talks about how everyone is so friendly and how job-sharing is really common if you want to take time to have a kid. Afterwards, I chat with her and mention the name of my supervisor. \u201cOh, he\u2019s my research supervisor too! He\u2019s amazing!\u201d I feel great again. What a small world! Or maybe that\u2019s just med.
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*Disclaimer: I know O&Gs who are very happily married with children. People going through acutely difficult times often project their own unhappiness onto the world. That being said, when she started going on about divorce and affairs, you might as well have called me James Bond\u2019s martini because I was shaken<\/em>.
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Entry 14 <\/strong><\/p>\n\n\n\n

I tell a med student I want to be a paediatrician. He jokes, \u201cOh, are you a paedophile?\u201d, which I find equal parts baffling and disturbing. Ironically, the next patient we visit is avidly watching the live sentencing of Cardinal Pell.
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Entry 15<\/strong><\/p>\n\n\n\n

I am taking a history: \u201cHave you ever used recreational drugs?\u201d The patient, a very serene looking bookish man with a pleasant pair of glasses on, laughs and looks down. \u201cUh, just write: \u2018Basically all of them\u2019.\u201d
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Taking another history, my young patient reveals his wife passed away a few months ago after a long battle with illness in this same hospital. He tears up when he talks about her. \u201cHow are you coping?\u201d I ask, but really, I don\u2019t know what to say. He shakes his head and says, \u201cWell, look\u2026\u201d but we are interrupted before he can continue. I feel awful for dredging up his grief, so after the interruption, I transition into asking about his hobbies as a roundabout way of assessing his mental health. He still plays soccer, reads all the time, and writes music, though he is shy about the latter. \u201cWhat genre of music?\u201d I ask, excited. He laughs and looks away modestly. \u201cOh, everything really. I like it all.\u201d I think he will be ok.
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