First Day

My white coat is a little big for me.  When I look at myself in the mirror, I can’t help but think that I look like one of those high school kids in those 80’s sitcoms. The sleeves are too long and must be rolled, the shoulders are big and boxy, and it really doesn’t quite hug the silhouette like a girl nowadays would like.   But still I like the crisp whiteness and all that it symbolizes in my life.  It has these silly pins that highlight my ‘newness’ to the profession, and even sports a tacky sign that merely says ‘observer, just because I know if I remove it, I will surely lose it and lose access to hospital shadowing privilege.  And the pockets are all filled to the brim with things that make me look like I’m actually doing something, like a stethoscope, a pen-light, blank H&P forms, and rubber gloves.  I walk out of my apartment with my coat on, and for a few, fleeting moments I feel like I’m someone important;  but I can’t fool people for long. 

 I have just finished the first year of medical school, and though I learned so much, I still don’t think I know anything.  Silly words like the Islets of Langherhan, and ketoacidosis, gracilis, medial lemiscus, MCAD and neuropathy all hold a glimmering significance in my mind, but ask me about BUN/creatine ratios and I just stammer and mumble excuses about renal physiology just being my weak spot. (It is. I hate the kidneys.)   With the first year being complete, I decided it would be fun to spend my summer pretending to be a doctor and getting as much clinical experience as possible.  The month of June is filled with a pediatric externship (Externship: noun: a required period of supervised practice done off campus or away from one's affiliated institution.)  and a trip to Kenya to work in a medical clinic there.  Part of my hope in make my summer so full of clinical experiences was not just to get experience, but to see the light at the end of the tunnel.  It’s very dark in the library, and most time you lose sight of the forest in the midst of graphs and facts that promise to be useful someday but really you can’t imagine how and you just stuff them in your brain anyway. 

My first day of externship at Kosairs Children’s Hospital was just, well, awkward. (You want to see everything, but at the same time, you want to stay as out of the way as possible.  "Do I sit in the trashcan or just as close to it as possible?")  My first assignment was to go to an educational conference, where all the residents, interns, and attendees sit and talk and listen to different cases and presentations.  As I looked around, I was a little intimidated with all the long white coats in the room and all the confidence.  These people were not just scared little plebian doctor wanna-bes; no sir, these people had run the gauntlet and had conquered it.  I’m sure they didn’t even notice me sitting there bambi-eyed and scared.  The first presentation was a pediatric neurosurgeon.  In the middle of his talk about the neuro exam, he casually exclaims ‘Oh hey! There are medical students in this room too!’  Indeed there were.  As I was sitting directly in front of him, I became the target for my first pimp (the medical pop quiz, to test you on your preparedness of your future profession. I knew my first pimp would come, but never thought it would happen in a room full of already accomplished doctors). 

“Since you were bold enough to sit in front of me, what is the evaluation scale we use to measure patients who are unconscious?”

I racked my brain for any clue, but not even the remotest sliver of the answer appeared.

“I’ll give you a hint, it’s named after a town in Scotland”

Edinburgh?  Brigadoon?  I didn’t know I would have to know geography too to be a doctor.

“Glagscow Coma Scale,” was the final answer.  I wasn’t the only person to miss an answer, but it would have been nice to know that one simple fact.  I’ll never forget it now, that’s for certain. 

Before I knew it, the presentation was over and there was a mad rush of people shuffling out the door to go about their business of rounds and reporting.  And there I was, without much knowledge of where to go from there.  Luckily there was a doctor who kindly gave up the run-down and introduced us to the teams we would be shadowing.  I was given to the Blue team. 

                An attendee, 4 residents, 3 3^rd year medical students, and a lowly rising 2^nd year make up team blue.  We travel in a flock for the most part.  We round together, and give report together.  We make quite a crowd, and I can only wonder what patients and their families are thinking when we herd into their room and talk about the number of bowel movements the patient had in the past night.  They were so welcoming, and eager to teach me all that they know.  I still felt in the way, as you do shadowing anyone, but it wasn't as bad as it could be. They had all been there before, they understand my situation and are more than willing to help.  At times there is nothing else to do but merely stand around and wait and that is just the reality of my position.  Thank goodness for the iphone (never in a million years did I think I would ever say that, but there it is.) that I can use to look up facts and distract myself with in those moments of waiting around for something to happen. These next few weeks will prove to be quite the learning experience for me as I see things, learn things, and do things that I have only seen and heard about in the classroom.