Almost Guilty
Man, it’s been at least a month, I’m sure. It’s been a great month, a
grueling month, and a rite of passage.
Hell no, it’s been longer. It’s been a couple of
months. I feel like I’ve passed from one lifetime into the next. I’ve
just stepped through a portal where I crossed over, and to which I will
refer in later years – how it used to be before everything changed.
“In a previous lifetime…” I’ll begin, and I’ll be
remembering the time that happened just before this writing. I’ll be
recalling the steady agony of studying every day for 8 to 14 hours a
day, with a couple of “off days,” during which I would only study five
hours or so. It will be the time I think back on when I struggled to put
it all together – how the body works, and how its processes break down –
two years of intensive higher learning reviewed in a months time. Man
I’m glad that’s behind me. As great as it is to learn so much about the
basics behind how we humans work, I’m damn glad the basics are behind
me.
I know, I know. I will always have to maintain the
basic science foundation to be able to make the best decisions in my
future clinical practice…but set it aside for a minute.
And breathe a Hallelujah.
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So I made it through the trial of a second year of
medical school in the U.S. To say it’s rigorous is like saying the World
Cup is a just another football match. To say the second year of medical
school will challenge you is to suppose that the Olympic trials might
test your limits. At least, that’s how I feel about them. Blessed,
glorious, and done…that’s all I have to say about that.
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Then came the Boards, which are known to some as
the first step, or “step one” of the United States Medical Licensure
Exam (USMLE). There are three or four of these steps, and between second
and third year of school is when most folks in the States take the first
step, with the necessary aim of passing in order to continue their
education.
Done and done. And thank you very much.
I do have to say though, that as usual, I studied
my ass off (I literally developed calluses on my bottom). I had high
hopes, but the first 150 questions hammered me into submission, and I
didn’t soar as I thought I might. Maggie, in an heroic and simple way
that makes up a fraction of her beauty, noted that I shouldn’t be
lamenting my failure to meet my goal. Instead, she said, I should be
celebrating the fact that I crossed an important milestone. She’s right,
and I am.
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And now, we are “on the wards.” We are in the
clinics and hospital and we are seeing patients and we are finally,
ultimately accountable to our patients, ourselves, and our Gods.
Under supervision, of course.
Finally, we are in the show. Our hits, our errors,
and our attention to the details are paying off in beautiful,
flourishing ways that were impossible to see in the deep, dark recesses
of book-learning, but that suddenly, given the light of day and the
bright light of the shining eyes in real patients…the facts come
together to make sense and whole out of a jagged piecemeal quilt of
abstract knowledge.
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I love my job. I get up at 0300 hrs, and I have no
hesitation in rising. I am so excited to get into the hospital that I
can hardly stand it. In fact, I usually wake up between 02 and 03,
nervous and excited to hit the day. I am having so much fun that I feel
like I should be getting in trouble. It’s like I get to sneak in and
open my holiday packages early. I’m having so much fun that I almost
feel guilty. Surely something this fun must have a price to pay. It’s
true that there is a price to pay, but part of the beauty is that a
great deal of the price has already been paid. It is as if the
finest piece of furniture is within your grasp, and you look at the
price tag, and realize that it’s far too much to pay. Suddenly, a tinker
bell salesman appears and reminds you that you’ve already paid a large
proportion of your dues, and you’re going to walk out with this item at
a 90% discount. You get to relax, learn, and have fun doing it. The
hours pass like minutes. The patients present, you alleviate their
ailments and their worries, inasmuch as possible as a mere student, and
suddenly 13 hours have passed since you arrived. And you are as
invigorated and jazzed walking out of the hospital as you were walking
in. What a privilege to qualify for a profession that permits such high
baseline joy.
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The highest privilege is being able to work with
people in times when they need medical assistance. The profession is one
of service, and that, I think is the cardinal rule that one must always
keep in mind at every single encounter with a patient. With every knock
on a door, at the other end of the room lies a person who has come
expecting from you the highest qualified, most informed advice,
technical expertise, and health planning available to them. If that
weren’t true, they wouldn’t be there. Either they or their family have
placed their trust in you and the institution where you are practicing.
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The second highest privilege is working with folks
who have made serious life-altering decisions to serve in the same
profession. I have never been surrounded by as extraordinary a group as
I have seen in my classmates, supervisors, and others within the health
care system. To say they possess something extraordinarily special would
be like saying that Sun sets in the West. Well of course its true. As
beautiful as a sunset is, it is the fact that it’s beauty is as
unwaveringly varied yet unceasingly mesmerizing – that is what makes one
hungry to come back for more. The talents and unending fountain of
enthusiasm that comes from the folks I have had a privilege to come to
know in our class seems without limits.
As much as it is a privilege to work within the
trust of patients, it is a privilege to work with my esteemed
colleagues. That interaction gets my up early with enthusiasm as much as
the interaction with patients. And once again, I am reminded of the fact
that Medicine is the most highly privileged of professions.
