200 Weeks
Isabel wood
Thirty weeks in and about 170 more to go - the path to becoming a physician seems to me more perilous and uncertain than it ever has before. Being here, as a medical student, has brought into brilliant focus the vast knowledge that I will need to assimilate, the countless paths to choose from, and the tension between my current self-conception and the identity of physician that I will assume upon graduation.
Three weeks in and it’s time to interview my first patient. I’m ready to ascertain the seven cardinal features until my patient reveals he has urine leakage. “Do I still ask about location?” I ask the supervising physician, his initial response laughter. I’ve been told these standardized patient interviews will soon become second nature, and I believe it. But when will interviewing a real patient come easily, a list of differentials expanding and shrinking in my head as I ask the relevant questions and auscultate the right places? Learning basic science and clinical skills on their own is challenging; combining them to care for a real person certainly feels like a distant reality.
My desire to be a physician has, for as long as I can remember, been inextricable from my desire to be a surgeon, my career path from college to medical school and ultimately surgical residency only ever a question of competency, not direction. Five weeks in and I’m scurrying after a team of surgical residents and their attending, my business-casual ballet flats conspicuously slapping the floor behind a sea of well-worn clogs and sneakers. The clinical knowledge is mainly beyond my comprehension, so my focus drifts to the patients and their families as we quickly flit in and out of their dimly-lit rooms; I share with them mutual glances of confusion, and in our shared confusion, understanding. I tell my mom later that I would have liked to spend more time with the patients. “You can’t assume it will always be like that,” she says, trying to comfort me. I get off the phone, worried that if I keep tugging on this initial thread of uncertainty my plans will unravel from their neatly coiled ball.
One week in and I walk into the hospital for the first time to meet my mentor in her office. Entering from the more muted, medical-school side of campus, I’m struck by the commotion and how much bigger the Dunkin Donuts is than the one I frequent in the new research building. With no scrubs or white coat, I blend in with the patients and families milling around the lobby. But there is one key distinction, a small ID clipped to my waist, the words “medical student” emblazoned in white-on-blue, small but distinct, erroneously suggesting to an innocent passerby that I can make sense of the maze-like corridors of the university hospital. She needs directions to the blood draw lab. “I’m sorry, I’m new here,” I apologize. “I don’t know where anything is yet.” Despite my initial alarm at being mistaken for someone who knows what’s going on, a smile creeps across my face as I continue along to my mentor’s office.
Six hundred weeks before starting medical school, and my life fundamentally changes. I’m not sure exactly what’s happened, but my parents are upset so I can tell something serious has occurred. Just a few milliliters of mysterious clear medication and I immediately feel better. I don’t understand that my life will now revolve around the contents of this vial, my 12-year-old brain only clumsily grasping at the gravity of this moment. I do know that I want to get up, exchange my floppy blue hospital gown for the crisp white coat worn by the doctor, and be busy and well. Twenty weeks in and I’m in ENT clinic when a patient tells me that he has type 1 diabetes. I wanted to enthusiastically respond that I did, too, and commiserate, the way we would have if we were somewhere else. Instead, I said “alright, and do you have any other chronic health conditions?”
It has been clear to me for a while that my desire to exchange a hospital gown for a white coat is simplistic. In the many, many weeks since my diagnosis, I’ve worked to resolve the tension I have felt between wanting to be perceived as unaffected by illness while also experiencing the daily challenges that come with chronic illness. Reconciling my identity as a patient and a provider will be a new challenge, alongside the many hours of studying and agonizing over career decisions that await me in the rest of my time here. Over the next 170 weeks of medical school, I hope to learn how to hold both of these identities at the same time. I hope that I won’t forget what it's like to be sick as I study the underlying mechanisms of sickness and care for patients. And most importantly, I hope that, one day, I can actually give directions.
Isabel is a first-year medical student who studied English and Neuroscience at Amherst College. She enjoys reading and writing and thinking about medicine from a humanities perspective.
