(no subject)
All through the first three years of med school, I missed literature. Like whoa. I read novels on the sly, attempted a little scribbling here and there, but really, the medicine really took over. It tends to do that.
And now that I'm given free rein to read and write to my heart's content, I am still dissatisfied.
I miss patients.
I miss sitting down with a person and leading off with my standard opening, "What brings you to clinic today?" ("The bus.")
I miss doing a physical exam. Especially the stethoscope. I feel naked without my stethoscope. I miss listening to hearts and lungs, and looking in the backs of eyes, and palpating abdomens, and pressing on legs ("have you noticed any swelling or your shoes feeling tight?"). I miss making people play "Follow my finger" and tandem walk and Romberg and pull tests and and and and.
Most of all, I miss the privilege and responsibility of interpreting those findings, in conjunction with the labs and imaging, to arrive at a diagnosis.
I really miss it. I've been devouring the New England Journal just to keep that part of my brain -- the thinking and diagnosing part -- in action.
I knew before now that third year -- the clinical rotations -- change you fundamentally, but I never quite understood what that meant. I need to be someone's doctor (medical student, resident, whatever). I need to be in that position of service. Right now, I'm not serving anyone, except myself. I worry that this year is an indulgence -- well, ok, it is an indulgence -- and what skills, exactly, am I getting that I wouldn't from just reading this stuff on my own?
It's not that the readings are uninteresting. I like the novels, the memoirs, the theoretical texts. Class is generally fun. But that's all it is -- fun. I'm past fun. I need utility.
I wanted to do this. I jumped at the chance. Perhaps I expected too much?
I've been spending a lot more time around the medical center recently. In the student lounge. In the cafeteria. People look at me funny, in jeans and without a white coat.
There really isn't a good way out of this dilemma. I had wanted to do an occasional Saturday free clinic -- maybe once a month -- but can't because it conflicts with the class I'm teaching. Then I was offered a part-time clinical position, but turned it down because of the time committment involved. I could contact physicians I've worked with in the past, but I'm not really looking to shadow anyone. I want to have patients, and I can't.
I realize that in the Grand Scheme of Things, my position isn't so bad. But it lends a new level of insight to, say, those physicians who train in a foreign country and then have to be cabdrivers or burger-flippers here. When I was at Harlem for peds, there was an intern who had been a peds ID attending in Iran. He was almost 50, and retraining to meet American standards. It seemed incomprehensible at the time -- dude, you're 50, do something else -- but now I get it.
I guess I was so busy missing literature that I never quite realized just how much I would miss medicine.