by Patricia Pang

At the core of the Doctoring Curriculum at Georgetown is the importance developing altruism and concern for each patient as a person, as well as the foundation for concern for the health of the population as a whole. One of the most significant outcomes of this class is my students’ realization they each experience doubt, elation, the thrill of discovery and humility. They are dedicated to becoming excellent and caring physicians. I am hopeful for the next generation of physicians and will be sharing their essays with you.

I carefully removed the last sliver of skin from Ruth’s face.  Two hours had whizzed by—more than enough time for the formaldehyde to settle in my hair.  This scent is the most persistent reminder that I am a first year medical student.  I relinquished my scalpel and gave my classmate a chance to see what our cadaver had to offer.  My work was done.  I had successfully completed a “face-off.”

I returned to my steel stool and surveyed the room.  The lab’s sole computer blasted mind-numbing beats, more likely to trigger a dance party than inspire careful dissection.  Some scowled at the noise pollution, longing for Mozart’s Requiem.  Others sang along as they performed their own face-offs.

The music stopped.  Sexual Development and Reproduction, or SDR, grades were up.

The SDR module was the Disaster of 2010.  We were condemned to writing a group research paper that was to be graded by our peers.  Fifty percent of our grades rested in the hands of our classmates.  As we were graded on a curve, the fear of being critiqued by a competitor grew more overwhelming than writing the 12-page paper itself.  Our Type A personalities did not mesh with the lack of control each of us had in our overall success.

As our peer critiques were returned, we realized many of our classmates broke the unspoken pact of guaranteeing passing marks.  The opportunity to professionally critique peer work quickly deteriorated into a savage situation reminiscent of Lord of the Flies.  Just as William Golding’s schoolboys failed to maintain order and govern with reason, many students seemed to sacrifice objectivity for their personal gain.  Stepping forth as a deus ex machina, our professor confirmed some papers were over-critiqued and entertained endless negotiations to reclaim points. Failing grades were retracted.  Tears abated.  Order was restored.

Was this a lesson in human behavior?

***

On August 7, 2009, I celebrated my 22nd birthday.  My parents gave me a new digital camera, assuring me that memories documented with 12.1 megapixels were much better than the five megapixels I had been slumming with.  My grandparents contributed money to be spent only on all the food they could not personally shovel onto my plate while I was away from home, in Washington, DC.  Standard birthday procedure in the Pang family.

This year was different.  I had something to share with them.  On August 7, 2009, I received my white coat in the presence of my family, beginning my first day as a Georgetown medical student.

Everything changed that day.  I felt confident as I entered medical school, recognizing that the transition would be challenging, yet knowing I would stay the course.

***

Tick.  Tick.  Tick.

The second hand circled the face of my alarm clock, carrying the hour hand closer to 9:00 AM.   It was 4:13 AM.  Panic mode had commenced at 11 PM the previous day.   I felt as if I were time traveling forward, acutely aware of the information I had yet to memorize.  Fifty histology slides later, I accepted my inevitable fate of walking into yet another exam just short of being prepared.

“Patti, are you up? It’s 8:30,” yelled my saint of a roommate.

Trying to act as if I had not slept through my two alarms, I replied, “Yes, Shuster.”  The second those words left my mouth, I knew it sounded more like “Yeaaashuusttrrrr.”

I got up, unfazed by my moderate tachycardia associated with slight nausea.  “Oh yeah, that’s right.  My body hates me.” I am delusional enough to think I test best when sleep deprived and slightly hypoglycemic.

The transition to medical school pushed me into reality.  I once had idealistic expectations of what I would achieve during my four years of medical school and beyond.  Now, I can think no farther than the scope of the current teaching module.  I have moved from the Gregorian calendar to an exam-centric calendar, conducting my daily schedule accordingly.  The closer we get to an exam, the more time I spend in the library, the more coffee I drink, and the smaller the ratio of time I spend with living human beings over the time I spend with Ruth, my trusty compa—I mean, cadaver.  This ratio instantaneously inverts the night after the exam, when our class celebrates the culmination of each respective hell week.  This binge and purge lifestyle has come to characterize my first year.

Medical students are expected to command an overwhelming fund of knowledge within a short period of time.  Libraries transform into trenches, overflowing with chronically over-caffeinated medical students who emerge only to refuel with even more caffeine.  Some rush to the coveted tables on the floor with windows, desperate to combat seasonal affective disorder by getting some sun through double-plated glass.  Others are resigned to a windowless existence.  Where I study depends entirely on my exam-centric calendar.

Compartmentalizing my life is the only way I can survive medical school.   Success in the basic science curriculum is my priority.  The usual activities of a responsible adult take a back seat.  Showering?  That is as optional as the doctoring curriculum lectures during exam weeks.  The short-term gain of doing well in my next exam takes precedence over any long-term benefits.  This lifestyle suffices as a coping method, but is hardly the optimal long-term solution for establishing a strong foundation for my medical education.

Do others feel similarly? With every seemingly insurmountable challenge comes a rush of bittersweet memories of my old, easier life, coupled with a hint of doubt in my ability to go on.  Every time I see the sun rise, I host a pity party for myself and struggle to remember why I chose the field of medicine.

Then I remember why.  How I have lost scope of things over time is unfortunate.  As I focus on surviving my first year in medicine school, I become more self-centered.  The acceptance letter to medical school did not come with a license to complain.

I chose this profession, knowing well that I was submitting to a lifelong commitment to learning and striving for excellence.

***

I passed.

SDR hardly qualified as the Disaster of 2010, as I thought of the devastating earthquakes in Haiti and China and the tragic crash of the former Polish president’s plane.  Still, it served as a reminder that circumstances can bring out our peer’s latent cutthroat qualities.  As physicians, we will relinquish our self-serving ways to be of service.  We will abandon our narrow outlook, recognizing that our own trials and tribulations are insignificant to our patients.  We will remain focused on the commitment we made to a career of lifelong learning.  Our medical education will serve as the forum in which we mature as healthcare professionals.  That is the goal—not our SDR grade.

On August 7, 2009, everything changed for Georgetown University School of Medicine’s Class of 2013.  As we grew accustomed to library cubicles and vending machine meals, we had to remember how we change in the process.  We must care for ourselves before we can care for others.  We medical students cannot lose sight of why we decided to become physicians, for we will continue to make sacrifices to achieve our goals in the field.

I was once a champion of embracing change, but now risk becoming a creature of habit.  As I continue my education towards a profession that prides itself on innovation and constant flux, I will remain open-minded.  The field of medicine requires that we not only be champions of embracing change, but also champions of effecting change.  Eager to serve others, we will persevere.  We must remember that we have made it.  We are living our dreams.


TDWI Writer’s Group member, Margaret Cary developed and teaches the Narrative Medicine/Personal Essay course at Georgetown University School of Medicine. Her students’ essays reflect their thoughts on being in medical school and becoming physicians.
Margaret Cary, MD, MBA, MPH
Maggi is a family doctor and leadership coach who engages her audiences in highly interactive presentations. Maggi is a doctor’s doctor with a physician’s mind and a friend’s heart. As an executive coach, she blends a scientist’s thinking with empathy. She is a constant learner and serial focuser with a lifelong passion for sharing what she’s learned. She is an inspirational motivator, occasional humorist, and excellent listener and storyteller. She translates the latest research in leadership development into her coaching process and into entertaining and highly interactive presentations. She is an author, trainer, facilitator, and teacher (Georgetown University School of Medicine). Her authenticity and ability to communicate and connect emotionally with her audience through storytelling—combined with just enough humor—result in rave reviews and standing ovations. She embodies a warm, sincere approach in sharing lessons learned as she guides you in creating your own Leadership Expedition. Email Dr. Cary at drcary@thecarygroupglobal.com to learn more.

2 COMMENTS

  1. I cannot help but be moved by your earnestness. You have no idea of the sacrifices yet to come–nor of the wonders you will experience from embracing the majesty of the afflicted. You speak of change and yes, there will be that, but some things do not change. It has been thirty-two years since I performed my face-off, and though we did not call it that, I did sit on a metal stool, and I did give my cadaver a name: Clyde. I called him Clyde, and I made my wife-to-be come and see him. So that she would know. Know the sacred thing I wanted to do. The basic science curriculum you fret over will come and go, and in its place will come new science, a new curriculum. But what will not change is the magic you will feel–an addicting jolt of goodness, really–the first time another human being stains your blouse with tears of gratitude and whispers in your ear, “Thank you, Doctor.”

Comments are closed.