In Their Shoes

When interacting with patients, it is hard not to project our own feelings on them and assume that they feel a certain way because of the disease or condition they have. Today, for instance, we had three patients during our clinical sessions--a boy and girl with Down syndrome, and a girl who had just come out of her battle with leukemia. The first thing that immediately popped into my head (and many of my classmates felt this way too) was how hard life must be, if I were in their shoes, to be dealing with all the consequences of their condtions--consequences that extend not only to the physical and emotional levels, but also play a significant role in their self image and social relationships.

Of course, we were surprised when their response was nothing like what we'd expected. The boy with Down syndrome said he's feeling great--he has plenty of friends (both with and without Down syndrome), and seemed to enjoy the prom they just had. It seems the difference we perceive between people with Down syndrome and people without was much more pronounced for us than for him, because we really don't have a clue what it must feel like in their shoes. Instinctively we assume that their condition would make their lives miserable just because it is much different from the life we're accustomed to, and it is hard for us to imagine that they can lead happy lives just like us.

When someone asked the girl who survived leukemia what it was like to undergo chemotherapy, her response was, "I learned to be really happy"--happy and grateful about the things that happened to her everyday.  It was her way of coping--looking at the big picture, focusing on what's important for her instead of getting bogged down by  little things and details in the process. Of course there was numbness and anxiety and all that when she first got diagnosed, but it was what she made out of her experience that made her story so moving. In her moments of uncertainty, of not knowing what will come next, not only did she not direct her frustrations inward ("oh, woe is me"), her response to this entire process was to create a charity to help other families going through the same thing.

People have very different ways of dealing with illness, and we have to really listen to their stories to even begin to "step into their shoes" and understand their experience. Being sick may be unsettling (to say the least), but it does not necessarily preclude happiness, as our patients today clearly showed us. We stress out so much about the little details of our lives--like our biochem test today--that sometimes we lose sight of our priorities. But our patients today have dealt with so much more than what we've had to deal with in the process of coping with their illnesses, and yet are still able to maintain their happiness and their outlook on life. This, more than anything, was what I think made their stories truly inspiring.

Playing "House"

Our small group PBL (problem based learning) sessions are just awesome. Today's case: 5 year old boy who recently came from Africa presenting with fever, chest pain with deep breath, leg and back pain. Without knowing anything about medicine, we were able to figure out the diagnosis--B thalessemia minor with sickle cell disease--just by discussing among ourselves and pulling ideas out of nowhere! And it was very rare too for these two diseases to be occuring together.

Our facilitator tried to guide us and steer the discussion on the right course, but mostly it was up to us to figure out which questions to ask regarding medical history, vitals, lab test results, etc. It was really fun and exciting--just like differential diagnosis on "House" (and of course lupus is ALWAYS a probable hypotheses =P). I learned a lot from everyone in my group, but I think the most important thing I learned was that you're not always right, even if you think you are. Everyone brings their unique insight to the table and only by working together were we able to put together all pieces of the puzzle. It took us two hours to figure it out today, and in real life we probably won't have that much time, but there was SUCH a rush accompanied by a sense of accomplishment when everything finally came together in the end!

In A Nutshell

After a fun and very eventful month adjusting to life in Nashville and Vandy, things have started to settle down and I'm finally beginning to experience what the daily routine of a medical student is like. In a nutshell: wake up, go to class, eat lunch, study, eat dinner, study some more, sleep, repeat. It's not as bad as it sounds, really. Sure, it's like drinking from a firehose--one of my lectures on the cell cycle today covered two months worth of material I learned in an upper division cancer biology class in one hour (80 slides)--but the fact that everyone's all in this together offers a kind of solidarity that makes even the most tedious 4-hr lecture-marathons at 8am tolerable, and even fun (in a twisted, masochistic way). It seems that the key to survival is twofold--keep up with the material (which is arguably the most difficult adjustment I've had to make coming to med school, but I've done a good job so far), and develop a good support network. A few of my classmates and I have been studying right after class everyday--we are such gunners, but who isn't anyway?--and it definitely boosted our motivation and made the process more fun and engaging. Although we are not always as productive as we'd like to be--like when our conversation on protein folding and stability somehow turned into gossip about our other classmates--I think whatever tradeoff in productivity is compensated by reduction of our stress level. We've also gotten to know each other much better since we hang out together all the time.

Speaking of my classmates, we have a wonderfully diverse class--diverse not just in terms of race/ethnicity or nationality or cultural background, but more importantly in terms of life experience--people with graduate degrees, people who have taken time off and gained significant experiences and wisdom, people who have lived in or traveled all over the world. Everyone is so smart and hardworking too. I feel incredibly honored to be starting my medical training with my seriously amazing classmates, and I think I can learn a lot from each of them. And although you just can't possibly like everyone, there are definitely people that I can see myself becoming really good friends with. One of the biggest lessons I've learned here is that you're not as unique as you think--when I was applying, I thought my life story (living around the world) was what will make me stand out, but in fact many of my classmates have also lived around the world, and in more countries than I have lived in. Sometimes I feel the "imposter complex" as our dean calls it--it's when you feel like they somehow let you in by mistake because everyone else is so much more awesome than you are. But I guess that just makes you try harder, so as long as it doesn't turn you into a gunner, it's not neccessarily a bad thing =P Our class in general is very close, and we've had a lot of fun together so far--there's always something going on each weekend and even on weeknights, so there is definitely time for you to take a break from the routine of class/study/eat/sleep.

 

I guess the secret to doing well is all in the balance, and in that respect, I definitely have a lot to learn. This past weekend I was out on Friday night and all of Saturday, thinking that I'd leave Sunday for catching up. Little did I know that I needed a lot more time than that to actually do my writing exercises, finish my readings and write an essay, and I didn't even attend all of the events I was planning to go to on Friday and Saturday. I am just amazed how other people are able to do it all--they are either incredibly smart, incredibly efficient, or maybe they're incredibly lazy like me and put off everything until the last minute and only give off the illusion that they're on top of things. In any case, I doubt anyone will actually fail out or drop out unless it is their choice (like they suddenly decide that medicine isn't for them). Vandy is very very supportive of us and they make it a big deal to promote our "wellness." It is just so different from undergrad, especially coming from a big public school for college. Everything is spoon-fed to you here, from all the free lunches, to the nice binders they put all your lecture notes in, to a multilayered advisory system (both faculty and peer mentors). No wonder people seem so happy here. I'm absolutely having a great time, even while being so busy all the time. In a nutshell: "work hard, play hard." That is the motto, and that's a pretty accurate description of my med school experience thus far--but I guess what they don't tell you is that the tradeoff is sleep. So far I'm surviving and in fact quite functional with about 6 hours a day, but I guess we shall see what happens when anatomy starts!

First Post

While procrastinating on my essays today, I decided it would be a good idea to start a blog to document my journey through med school. I thought it would be useful to write down the little insights and revelations that come along from everyday experiences, because too many times I let these moments of enlightenment slip past me just because I don't make note of them. It will be like a little documentary--maybe someday I'll make an autobiography out of it, haha. So here it goes - may this journal be as enlightening to you, my dear readers, as it will hopefully to be to me.