I’ve noticed a huge shift in my thinking as a medical student. As in, I finally feel like I’m “thinking like a doctor.” I’m not alone in this, as many of my classmates have said the same thing as going through our first year notes in studying for the comp. But I feel it’s particularly astute with me. I was a terrible student in first year. Honestly, I’m not exaggerating at all when I say I truly didn’t behave as if I deserved to be in medical school. I’m almost certain, looking back, that it had to do with my insecurities of being admitted without really trying. For some reason, instead of trying to own up to the opportunity I’d been given, I backlashed and refused to accept that I was in a professional program where people’s lives would be in my hands. I continued to study “for marks”, ie. if it wasn’t going to be tested, there was no chance I’d look at it. It was even worse than in undergrad, where I actually enjoyed learning especially getting to the level where I got to pick any courses I liked. On the contrary, in the first few months of med school, I didn’t allow myself to enjoy anything I was learning. I criticized every aspect of the curriculum that I could. I tried very hard not to take anything seriously. I refused to make any sacrifices to my social schedule, insisting that I would maintain relationships with my undergrad friends and that my getting into medical school wouldn’t change anything. Incidentally, I just started reading The Catcher in the Rye, and I already see my immature first year self in Holden Caulfield.
So that’s why I think the change in my learning might be a little more dramatic than my peers, because mine is more of a change in attitude. I can recall some of my colleagues in first year always trying to put things together, asking themselves why one symptom might cause another or how one lab value affects the rest, and my reaction to it was along the lines of “pfft, keeners.” Thankfully, it all feels very different now, and I’m a little more embracing and accepting of the fact that yes, I will be dealing with real people and whole patients, whose concerns I need to address from A to Z. All in just a few short months.
No coincidence that oncology block is our last before entering clerkship, and no doubt that the administrators chose to purposely integrate all our previous units. Suddenly we’re dealing with hypercalcemia and having to remember how a kidney works, and prescribing morphine derivatives that we learned in psych, and reliving all of immunology block when learning about the effects of cancer on blood and the immune system. The whole notion of palliative care makes me wonder just how thorough a physician must have to be when dealing with such a sick patient who could at any time develop a new symptom in any system in the body, and dealing with that symptom could be a matter of life and death. And most certainly how you deal with a patient’s suffering makes a world of difference to them and their family. It has truly been a wonderful and cohesive finish to the year, and I’m surprisingly sad that it’s almost over.