Heart of the Matter

The reality of medical school has hit, and I am trying to get use to all the feelings that coexist at the same time: 1. feeling overwhelmed, and behind with the work load, 2. excited about all the cool new things that I am learning, and 3. tired, tired, tired. Yes it’s true, medical school is a marathon and I have just shot out of the starting gate.

Last week was our first exam. Tension was high as everyone crammed as much as possible into the time available to study (outside of eating and sleeping, and sometimes instead of), not to mention all we crammed into our heads (I swear we MUST be growing new neurons in our brains). We all breathed a sigh of relief when it was over, and then waited anxiously for the results. Our scores would determine not how we rank in the class, but rather, whether the amount of time we have spent studying is enough.

OHSU has a grading system of satisfactory, near honors, and honors. There is a saying in med school that C = MD, and a joke: “What do you call the person that graduates at the bottom of his or her med school class?” DOCTOR! Ha Ha Ha. So no, the grades aren’t really that important, and you can study just enough to get by, BUT, we have to know all this stuff to do well on the board exams, so we may as well study our little tushes off. After all, we signed up for this marathon right? No one forced us to send in all the countless applications; no one forced us to sign on the dotted line; we chose this and so…… we study, study, and then study some more. I myself, even though I like getting good grades (stroke stroke for the ego), am more propelled by the desire to KNOW what the body is made of, how it works, and what happens when things go wrong. I love what I am learning, despite the fact that I get tired, overwhelmed, and feel behind. I’ve decided that I can feel both – I can love medical school, and feel the strain of it simultaneously. (some would call this masochism I know I know….)

So guess what we did the day after the exam? Got up early to go to lecture, and then move right on in our dissection of the chest area. There is no rest in this race (that’s why the second year students advised us in orientation to pace ourselves, now I get it). We opened up the chest cavity, cut out the lungs and heart, and held them in our hands. Nothing before in my life has prepared me to hold a heart in my hands. To see and feel all those little parts, valves, and muscles that are at the center of life, was astounding. The heart is a perfect pumping vessel: the first functioning organ in the embryo (a mere 24 days after conception), which will then beat millions of times until it’s very last beat, heralding in death. Life begins and ends with the heart, and we have therefore spent countless hours in lab and lecture, learning the secrets of its development, the mistakes that cause defects to arise, and the journey of blood through its chambers.

Of course there is more to medical school than tests and studying. We are also challenged to learn another central tenant of the profession of medicine – how to act, dress, question, and answer like a doctor. This is where our clinical preceptorship comes in, as well as the readings for our Principles of Clinical Medicine class. The case studies we read about will (hopefully) encourage us to develop the other non-intellectual muscles. We pretend in small groups to be patients and doctors; we make up stories and practice listening to each other’s hearts, as well as doing physical exams of the joints. I know I’m in the right field when I remember what I used to play at when I was a child. I played doctor! And now I get to play doctor again, except now the stethoscope is real, and soon, the patients will be real also. This, more than the tests, the memorizing, the studying, this seems to be to be the heart of becoming a doctor. I look forward to more play time, and more studying!

“It is a burden and a privilege to bear witness to patients’ suffering and to intervene on their behalf.” Mark B. Mengel, 2002

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