I’ve mixed feelings about this year. But none of that bittersweet stuff. No, this is an absolute dichotomy. Love, meet hate.

To catch you up, this is my 4th preclinical quarter (out of 6 total). I’m a second-year. You do two years in the classroom, and then two years in the hospital. In year two, they really turn up the intensity. I basically spend my days in class, and my evenings studying. Every three weeks, we have a block exam covering the physiology, pathology, pharmacology, histology, and microbiology of the organ block we’re covering. In non-medical-geek speak, that’s: how the system works, how diseases of the system occur and progress, how you treat the diseases with drugs, what the system’s cells look like under a microscope, and what bacteria/viruses/fungi/parasites infect the system and cause disease. You can imagine-or maybe you can’t-there’s a lot of stuff that can go wrong in our bodies. Most of the time it goes right. But then you wouldn’t be seeing a doctor, would you? *

So I go to the library, take out my lectures, review books, and TA handouts, and memorize. Pages and pages of facts. Some of which makes logical sense, based on the basic knowledge of how the body is supposed to work, but other times, it’s just rote, bland memorization. For example: there are a ton of types of liver cancer . That list is just the tip of the iceberg, and is 2 pages of a 17-page Word document that contains all the pathology I need to know for the exam. The human brain is not meant to take in this much information, repeatedly, in such a short span. I promise. And, because we clearly have nothing more important to do or learn, we get to memorize random facts about liver cancers, most of which we will never, ever, ever see. This would be where that whole hate thing comes in. Also the tests every three weeks is a major source of frustration. But more on that later.

So contrast all that fear and loathing with the other side-I finally feel like I’m becoming a doctor ! Ahh, love! All this work, all this perserverance, and stuff is starting to finally make sense! I get it! What a feeling. We see patients once a week, and, get ready for this: they actually have the symptoms we’re taught about! And they’re actually on the drugs they tell us we have to learn! It’s this light at the end of the tunnel. It’s this belated acknowledgement that yes, what we’re learning does apply to actual people; it doesn’t exist in a vacuum, or only in our heads or on our tests.

Another, more subtle benefit of the “test you every three weeks until there’s nothing left” mentality, which I think will probably never leave medicine, and perhaps for good reason: I no longer seem to stress over tests, or many other stressors in my life. I’m much more content to just feel confident, do my very best, be true to myself about my work ethic, and just think calmly. I was a nervous wreck in undergrad (a story for another day), and while I still get butterflies as I’m biking to a test in the morning, it’s nothing like it used to be. I’m guessing this is some sort of unintended positive consequence of medical education: I’ve grown almost Buddhistly- detached from the testing experience. I accept it as part of the process, but realize that it is, not really, a great reflection of my ability as a physician or human being.

* A great proverb (I’ve heard Chinese, but who knows) goes something like this: How would the world be different if you paid doctors when you were well, and they paid you when you were sick? Talk about preventitive focus. Take that one and and munch on it.

2 Comments »