Mid Life Crisis

When I was considering applying to medical school, a friend suggested I talk to his father, “Mr Goodstuff” who used to be a university admissions tutor. He wasn’t involved in admissions for medicine, but I jumped at the opportunity and spent time on the phone with him discussing how to stand out from the crowd (as if at my age I wouldn’t) and I emailed drafts to him to polish up my application.

I remember his exact words: “Don’t worry, we will get you into medical school” and I was genuinely reassured when he said them. It helped me gain the confidence to believe that at my stage in life it wasn’t such a crazy thing to do after all and I almost began believing that people were taking risks by quitting good jobs and applying to medicine all the time. Recently, my friend Goodstuff junior, told me that his father had actually been quite skeptical about my chances of success and was pleasantly surprised that I had got in! Insert facepalm here. I have yet to properly thank Mr Goodstuff for helping me so for now at least – thank you!

The other words I remember him saying were: “You’d better make it look like you’re not going through a mid-life crisis.” If I understand correctly, an applicant’s age is not shown on the application but if you’ve worked before and done other things, the medical schools could have a good guess from your previous experience and they’d certainly have more than an inkling at the interview stage when instead of a fresh-faced 18-year-old youngster, they would have homely me sitting in front of them.

I never realised that my application might be seen as a mid-life crisis and the phrase ‘middle-aged’ made me stop and think: “Wait, does that phrase actually apply to me?” What happened? Am I middle-aged? Well, perhaps not when I applied but now a little older, I suppose there’s no denying it. Like in the ER, when a patient receives the explanation that poor diet, lack of exercise and a gradual build up of cholesterol and plaque is causing them at that very moment to be having a heart attack – is medical school a manifestation of a mid-life crisis and I’m having one right now? Did I fail to recognise the biological signals telling me to shop for a new wardrobe, dye those grey hairs, find a lover 10-20 years younger and applied to medical school instead?

I don’t think so, but if this is a midlife crisis, it’s not too bad a crisis to have. I had my end of year examinations a few weeks ago, the results of which I found out recently. I passed the 4th year! So after the summer I’m on the home stretch. That impossible summit might just be reachable and I may actually become a doctor. Final year here I come!

Well, here I come, after perhaps: a blepharoplasty, a tummy-tuck, joining that gym…

Advertisements

Family & Friends

During revision and in the run up to exams I see exponentially less and less of anyone and eventually become a hibernating hermit hedgehog. It becomes awkward to continually turn down invitations to go out but it would be “frivolous” to chuck my books in the air whenever such an opportunity arises. Petrified of the consequences, I make my excuses.

The friends I do see are fellow classmates at the hospital. “What is the dosage of that drug again? Should the patient hold in inspiration or expiration when listening to a certain heart valve? Which cranial nerves are we likely to be examined on? This is what we discuss as we dash between clinics and bedside teaching sessions and everyone else except me seems to know all the answers. Dare I say it – I’m turning into an old bore, like really old bore.

I’m unsure if there is less time because of medical school or because there are more “chores” to do as we get older but unfortunately whatever the case, I’ve generally seen less family and friends since starting medical school. In the meantime, they’re getting new jobs, buying houses, giving birth or visiting exciting places around the world – whilst I admire from a Facebook distance.

So my dear family and friends, I’m sorry I sometimes can’t join you and I hope you are having a great time. I’m sorry for my enthusiasm when I recount what I see in surgery and clinics and not talking about anything else (mainly because I haven’t done anything else worth talking about); for recalling obscure and gruesome medical facts that won’t affect you; for complaining about the speed with which I hurtle towards exams and for worrying about how much I feel I still don’t know.

I’ll be back to normal shortly, I just have to get through this medical degree…

Halfway There

Halfway to Doctor Motorway Sign
Just passed this roadsign on my journey…

Halfway through another rotation and it all seems to be going well. We are now actually halfway through medical school  – at least from a time point of view and I’m surprised to feel that it’s gone so fast, although there is still a ton of continued learning for years to come. I certainly don’t feel as if I’ve travelled far enough along this journey or know enough to have reached the destination of half a foundation (F1) doctor. According to good old Wikipedia, I’m currently at the stage of “consciously incompetent“.

Although I’m confident using my stethoscope, it may be some time before I wield it with the same precision as Jedi consultants and can detach it from my neck without tangling it up in my ID badge neckstrap. It doesn’t inspire confidence in patients when your ID badge somehow ends up in their mashed potatoes.

I’ve met all kinds of patients with interesting jobs including a footballer, an athlete, an actor, an airline pilot, several doctors and even a professional clown. It has been pretty awesome.

Perhaps, my classmates and I are stressing too much about not knowing enough to be helpful and should just enjoy this stage where we can absorb and see a massive variety of specialties without being tied down to any of them – or be expected to carry out jobs or endure any huge responsibilities yet.

The “Medical Student” ID badge (when freed of potato) grants us “Access to All Areas” in the hospital and observe pretty much anything we’re interested in. Clinics and operating theatres may need prior arrangement but by asking nicely, I’ve often been able to show up ad-hoc even to these and watch procedures, get a bit of teaching and see conditions that we’d only previously read about in textbooks.

So we are not VIPs, but we do have backstage passes. Roll on the next 2.5 years – if all goes well.

Scrub Nurse Angel

Surgical_gloves_19Observed a prostate biopsy today. After the patient was wheeled in from anaesthesia, the consultant told his surgical registrars to do a digital rectal examination on the patient to feel the prostate’s size and its nodules.

An orderly queue formed at the foot of the table, index fingers held up as though testing wind direction. He then motioned to me that I should also become familiar with what a prostate with pathology felt like.

Accepting the fate of my finger, I donned the gloves and joined the line. I shuffled forward to take my turn and just as I reached the patient, someone shouted that the patient had not yet been ‘taped’. I stepped aside to avoid the scrub nurse as she sprang into action, taping certain appendages out of the way and then immediately afterwards the surgeon moved in to start the procedure. I was saved – thank you scrub nurse!

Clinical Week 1

Beilinson_Hospital_ward_1950I’ve survived the first clinical week. After two years incarceration in mostly lectures and the recent week of back to back induction talks, my patient hungry classmates and I were released into hospital wards.

However, the new found freedom we’ve been craving has sometimes left many of us feeling like spare parts, trailing behind junior (F1) doctors and not knowing enough to help properly yet. We’re dressed as doctors, reinforced by shiny new stethoscopes around our necks but with little experience of using them.

I’m not beating myself up as it’s only the first week and we’re still discovering hospital protocols but so far a good recipe has been to i) find a cooperative doctor ii) be nice to nurses and iii) find friendly looking patients who will consent to histories and examinations.

Me: “Hello Mr X, my name is MSL and I’m a medical student. Could I talk to you about why you’re in hospital?”
Patient: “Sure doctor”
Me: “I’m actually still a medical student”
Patient: “Oh, OK”
Me: “So Mr X, why are you here today”
Patient: “Well I’ve had this pain for 3 days now doctor”
Me: “I’m a medical student
Patient: “OK doctor”

My initial concern about being mistaken for a qualified doctor is semi valid for some patients but is wasted on staff who look me up and down and spot my “Medical Student” ID badge, Oxford Handbook of Clinical Medicine (aka cheese and onion) or notice me waiting around awkwardly. Actual doctors have a pager clipped to their belt/handbag and hurry around efficiently with patient lists in their hands. The pager is like a little time bomb except nobody knows when it is going to go off. Consultants walk around in expensive shoes and suits – no pager.

So far so good, not many pointy questions and no humiliation in front of patients yet but I did hear a rumour that a consultant made one of the doctors cry.

Clinicals Here I Come

In years 1 – 2 we achieved most of our learning through lectures with regular but occasional placements in hospitals plus sessions with GPs (family doctors). 3rd year means starting the clinical part of our medical education where we’ll be members of a “firm” in teaching hospitals and seeing patients full time. I love patient interaction so this is an exciting transition and is the stage of medical school that I’ve been really looking forward to. I still have to kind of pinch myself to prove that it’s happening!

Part of me is guarded about what being in a clinical firm will be like as an extra mature student. Traditionally, age correlates with seniority and students are the youngest in the firm but in my case, there’s a good chance I’ll be older than even the consultant. Until now it hasn’t been an issue and In a lecture hall I’m just another face (albeit a wrinkly one) in a large crowd. A clinical firm is a small team so I’ll stick out. How will I be perceived? Could I be mistaken for a qualified doctor or even as an old fraudster impersonating a medical student?

I’m also wondering whether I’ll be able to answer the questions that consultants and registrars will throw at me. Do they really humiliate their students and juniors? I’ve learned an amazing amount since starting medical school but I feel that I’ve forgotten a lot too. My classmates have voiced similar concerns and we’ve been told: “It’s in there somewhere and comes rushing back when you need it” – Well I hope so as I’m going to need it all very soon and I don’t feel anything rushing about up there.