Note: One of the more time-consuming and difficult things you must complete for your medical school application is a personal statement. It essentially provides an opportunity for you to tell admission committees who you are, what you value, why you want to be a doctor, what makes you different from the thousands of other applications, and anything else that doesn't really fit into the tidy little boxes on your AMCAS application. It’s an important part of the application for all schools, and a crucial part for some. Outside of your transcripts and whatnot, this is your only chance to convince the school to consider you for an interview.
I briefly wrote about how to formulate a personal statement here in the “How to Get into Medical School” series. One of the more difficult parts of writing it, for me, was not really knowing what it was even supposed to look like as a finished product. With that in mind, I've decided to post mine here – not that this is the only way to do it, by any means, but it’s one way. Whatever you end up writing, you'll most likely think it's the most amazing thing at the time, only to cringe when you look at it several years later (little heavy on the melodrama in mine, I think...). Regardless, I hope that it might help point some of you who are trying to compose your PS in the right direction. Good luck.
Death was no stranger to me. But this one was different--I knew her. I was working in the patient transport department in a large hospital in Portland. I was new, and only had been working for about a month and a half. It was the middle of a moderately busy Friday evening shift. I sat down to rest my weary feet and to pick up a new job over the phone system. An automated voice came on the line, telling me to take a patient named Katie from the seventh floor to the morgue. My heart sank. I knew this woman. I had recently transported her, and even though she was in the hospital and obviously sick, she hadn't struck me as someone who was on death's doorstep. She was young--not even forty. Yet here I was, picking up her morgue job. I hung up and reached for the morgue key. The key was attached to a trapeze handle, apparently to make it easy to find. Most of the trapeze handles in the hospital were bright colors. This one was black. Fitting, I suppose. I left the transportation office, obtained a gurney and a blue tarp to place over the former patient, and began the long walk to the seventh floor of the hospital. The seventh floor, by the way, was the Oncology unit. Katie had died of cancer.
Death hadn't really bothered me until Katie. But Katie was different. Cancer had struck her down when she had so much life left. And even though I had not really known her, I had cared for Katie and talked with her. She had, to me, been a real person, while the cadavers in anatomy lab and bodies of other patients had been anonymous. They had lived their lives, of course, but I had not been a part of that. With Katie, I had. Who could have known, on that day that I transported her just a few weeks ago, that I would later wheel her dead body to the hospital morgue? Sorry, Katie. We have failed you. Cancer has won this battle.
This was not the first time I had encountered this sense of helplessness. A few years before Katie, I had the opportunity to travel to Africa. While I was there, I was mentally wrestling with myself about the future. When I was younger, I thought I would go into law. The idea of being presented with an issue, thinking through all aspects and perspectives, and then using logic and argument to debate for one side appealed to me. The thrill of the contest seemed to provide a rush like nothing else. However, in my first college English class, we were assigned to write the quotidian research paper. I chose to focus on the medico-legal aspects of stem cells. Although here again I found the excitement of laying out all sides and making my case, there was something new here. The potential capabilities of stem cell applications in particular, and medicine in general, contained within themselves the possibility not only of captivating intellectual opportunities, but the real ability to radically change people's lives in a tangible way. It was then that this usurper of my attention, medicine, entered into my life. I knew it had the potential to cause change, and in Africa, I saw the great need for just that. We spent some time in Kibera, the second largest slum in Africa. People were living in huts built from sticks and mud. Hygiene was poor--walking along the narrow roads between huts, it was generally best to not dwell on what was underfoot. There was no running water, no formal sewage system. Disease, including HIV/AIDS, was widespread. Change was needed here. These people needed social help, political help, economic help--but first, they deserve at least to live. To not be plagued daily by easily preventable diseases. Medicine was necessary for this to become reality, to begin to effect lasting change--and I deeply desire to play a part in this.
A year later, I was working as a lifeguard back in the United States. It was here that I experienced a rudimentary exposure to medical care, particularly emergency medicine. The thrill I thought I had found in simple debate was exponentially replaced by the high that came from being presented with an acute problem, whether a simple injury or a drowning patron, accounting for a number of factors that play into the situation, and responding in a way that effected, often, a measurable relief. I thoroughly enjoyed it. To further explore this, I volunteered in a local emergency room, became trained as an EMT, and worked as an ED Scribe. The more I traveled into the realm of medicine, the more hooked I became. But in all these positions, the limited level of care I was able to provide bothered me. I wanted to be able to do more for those I cared for.
The majesty and brokenness of our inner workings have always intrigued me. But what was crystallized for me in these experiences was a deepening of my desire for change; an urge to take up the weapons of medicine and join in this bittersweet war between life and death--the ultimate debate. Death is sometimes an ally, but all too often an enemy. I want to fight for those like Katie, for those who live in Kibera, and for those whom Death strives to take too soon after they have lived lives of despair. This is a war that must be fought on many fronts, but one that I desire to fight as a doctor.
Friday, December 13, 2013
Saturday, November 2, 2013
How to Study in Medical School
In an older post, I wrote a little bit about my search for efficient study tools for medical
school, and how I eventually discovered Anki and OneNote. To briefly summarize,
I spent part of the summer before school started trying to figure out how I was
going to study. I knew it would be a different ballgame than undergrad (and
that turned out to be true), so I figured my old methods wouldn't work so well (which would also be true...).
In undergrad, I usually just went to class, took notes in a binder, read any
assigned reading, and reviewed everything once or twice in the day or two
before the exam, depending on the class. For medical school, though, I knew
that I would need a way to take in more information, organize it, and review it
more than once or twice.
After poking around the internet a bit, I settled on Microsoft’s OneNote to take notes (if you have a PC, I highly recommend this program. If you have a Mac, I don't think it's available. I have heard good things about Evernote, though, which is available on both platforms. That said, I prefer the organizational structure of OneNote over Evernote – both are good programs, however). This was a great way to 1) cut down on what I actually had to lug around 2) organize everything in one searchable, legible database (this latter point is important, as my handwriting is chicken-scratch) 3) and take more notes much more quickly than I could write them, while also incorporating various media as needed.
Note: These aren't my videos, but I think they give a great overview of how to use OneNote and Anki.
After poking around the internet a bit, I settled on Microsoft’s OneNote to take notes (if you have a PC, I highly recommend this program. If you have a Mac, I don't think it's available. I have heard good things about Evernote, though, which is available on both platforms. That said, I prefer the organizational structure of OneNote over Evernote – both are good programs, however). This was a great way to 1) cut down on what I actually had to lug around 2) organize everything in one searchable, legible database (this latter point is important, as my handwriting is chicken-scratch) 3) and take more notes much more quickly than I could write them, while also incorporating various media as needed.
Below is a
great video describing how one can use OneNote in medical school. Everyone
might do things slightly differently, but this provides a good starting point.
Note: These aren't my videos, but I think they give a great overview of how to use OneNote and Anki.
If you have
a Mac, then I’d suggest checking out Evernote. Click here for a
basic overview of how to navigate Evernote.
If you used
paper in undergrad, like I did, you might think that you’d rather just keep
doing that. And that’s fine. But if you can, I’d really recommend switching to
a computer-based note-taking program. I have found it to be much faster and
more efficient. It allows me to pretty much have access to every note that I
have taken at all times, search the entire database, and sync it all in “the
cloud” so that, if I were to lose my laptop, I could be up and running on any
other computer in the time that it takes me to log in to SkyDrive. OneNote’s
built in screen-capture feature is also a very helpful tool that I use on a
daily basis.
So I had a
good way of taking notes. Great. But how would I review them? It is a common
refrain among medical students that you can expect to forget pretty much
everything you learn in the first couple of years. That may be true, but that
didn’t sit well with me. I’m sure most of what we learn is irrelevant, and that’s
fine, but not all of it is, and a large chunk of what we are learning we’ll
have to know for the boards. So I started to wonder if there was a way around
that…and found Anki.
Anki is
essentially a free flashcard program. You create the cards, review them, and
then the program will use a spaced-repetition algorithm that makes certain
cards due at various intervals, depending on how well you could recall the
information. (Update: I've written a brief Anki Q&A here.)
So, for
example, you make a card. Right after making the card, you review it. It’s
pretty easy, and you answer it correctly. The next day, the card is due again.
Again, you answered it pretty easily, so when Anki gives you the option of
choosing how well you recalled the information (generally something along the
lines of “again,” “hard,” “good,” or “easy,” with each option being associated
with a certain default time interval, like “10 minutes,” “2 days,” “3 days,” or
“4 days,” respectively), you select “good.” In three days, the card becomes due
again. If you again select "good," this time the time interval might be “5 days,”
and so on and so forth.
Taken from this random website |
You can see
in the graph how this works out over the long term. After we learn something,
that knowledge immediately begins to decay. However, we can slow that knowledge
decay by exposing ourselves to that information again within a specified window
of time. Over time, this spaced review strengthens the memory of whatever it is
we are trying to recall. Sounds great… but the trick is to figure out when we
need to review the information. With physical flashcards, this quickly becomes
tedious (especially when you accumulate thousands of flashcards...). With notes, we might review those a few times before a test, but then
probably never really look at them again. With Anki, you don’t even have to
think about it. Anki does all of the work, and uses your answers (whether the
card is hard, good, or easy, for example) to create a personalized scheduling
algorithm for you.
So how do
you use this in school? There are many different ways to use it, but I’ll
briefly walk through how I’ve been using it. After lecture, I review my notes
and find important concepts, ideas, or minutia that I feel I need to know. It’s
important here to distinguish between things that only the professor would ever
ask, things that you might actually need to know for boards, and things that
you simply find interesting and/or helpful. For the most part, you only want to
make cards for things that fall into the last two categories. That said, you
can make cards for things in the first category and “suspend” them after the
test – that way, you reap the benefit, at least in the short term, of spaced repetition
while avoiding making your daily reviews in the long term too long.
I would
recommend trying to only make 20-50 cards a day (ideally), with an upper limit
of 100 new cards per day. When making new cards, there are some rules that you
should keep in mind about how to make efficient cards – you can (and should) read them here. If the cards that you make are junk, then Anki will not be
beneficial for you. Right after you make the cards, be sure to review them. Additionally, it can be helpful to tag the cards as you make
them – so, for example, if you are making cards about the upper extremity in anatomy,
you can tag them all under “upper_extremity” so that you could pull all of those
cards out later for a dedicated review, if you so desired. You can also tag by
source – for example, if you wanted to check what you are learning in your
classes against a gold-standard source like First Aid, you can tag any info
that is in First Aid with an appropriate tag so that you can review it later or
just to remind you not to suspend that card down the road. Again, while it
would normally be a waste of time to look at a source like First Aid in your
first year, with Anki this is no longer true, because you will actually
remember the information. Ideally, this will help you later when you do begin
to study for boards.
There are
also different types of cards you can make. You can make straight flashcards
(e.g. prompt on front, answer on back), you can use something called cloze
deletions, or you can use image occlusions. There are many other types of
cards, but these are the three types that I primarily use.
Cloze
deletion and image occlusion are powerful tools, and are perhaps best
illustrated by video. So below are some relevant videos that provide a short
introduction to how to use Anki and create those types of cards. I highly
recommend taking the time to watch them.
Now you’re
ready to get started. Go here to download
Anki, and here
to see the user manual if you have any other questions – although, if you’ve
watched the above videos, you should have a pretty good handle on things.
Finally, if
you ever have any problems with Anki, following the instructions in the video below
should fix them.
Once you’ve
made the cards, make it a point to review them daily. Just get it done – you’ll
be glad you did later. It might take a little more time up front to create the
cards and spend time reviewing them, but when it comes time for a test, I think
you’ll find that you’re a bit less stressed about it and are able to spend less
time trying to cram information in your head. Usually for tests I just
passively review my old notes once – quickly – just to get a “big picture” review
and to go over anything I specifically marked as something I should review (for
example, if I didn’t put something in Anki because it is important for the test
but for absolutely nothing else in life).
Also,
reviewing them can be done on the go. There is an Anki app for both Android (free)
and iPhone (not free, but worth it). For example, I start reviewing cards in
the morning while eating breakfast, while walking from the parking garage to
school (which would otherwise be a waste of 5-10 minutes, and during which time
I can get through a bunch of cards), in between classes, etc. This allows me to
sometimes be completely finished with my daily review by the time I get home,
or at least have a significant portion of it knocked out.
So that’s
OneNote and Anki. These are very powerful tools. There are, of course, many
ways to get through medical school, but, at least for me, these programs have
single-handedly gotten me this far, and I plan on continuing to use them throughout
the rest of school.
Saturday, October 26, 2013
Rite of Passage
We’ve
survived.
The first
anatomy exam is over.
*insert sigh
of relief here*
As I wrote about previously, Loyola just changed up their anatomy curriculum.
Most of the changes, at least in my opinion, are for the better. The one change
that we were all nervous about, though, was the switch from in-lab anatomy practical
exams (where you wander around in the anatomy lab and try to identify labeled structures
on cadavers) to online practical exams (where the instructor takes a picture of
the labeled structure, and you have to figure out what in the world you are
looking at).
From Anatomy at the Bleeding Edge |
Intuitively,
it seems like an in-lab practical would be the better course. With anatomy, it’s
often helpful to be able to orient yourself to the region of the body you are
in and look at a labeled structure from several different angles while you are
figuring out what it is. With a picture, on the other hand, we were afraid that
we wouldn’t really be able to orient ourselves or see the structure clearly.
Looking at pictures of a cadaver can be an entirely different experience than
seeing one in the flesh (I know, that was
too easy…). In fact, having done a couple of online practical exams as
practice before the test, I know all too well that badly-taken pictures can be
downright frustrating.
Despite all
of that, the general consensus among the students – and I agree – was that the
instructors did a great job in creating the online practical. All of the
pictures were of good quality, structures were pretty clearly labeled, and they
did a good job of orienting us to the region by showing us where exactly in the
body we were and making an effort to clearly show neighboring structures.
There was
also the benefit of being able to take your time while trying to identify a
structure. I took anatomy in undergrad (and
subsequently forgot everything…but ah well), and we had in-lab practical
exams. These generally consisted of a large mass of students wandering somewhat
aimlessly around a locked-down laboratory with a sheet of paper, a clipboard,
and a pen. While it is helpful to be able to look at a given structure from
multiple angles, at the same time you did feel somewhat rushed by the bolus of
students coming down the line behind you. With the online practical exams,
however, you could stare at that darn picture however long you pleased, thank
you very much. So that was nice.
I was pretty
happy with the results of the exam. The class as a whole did pretty well,
actually. Anki
really shines in anatomy, particularly the image occlusion feature,
which allows you to screen-capture a picture from your computer, cover labels,
and quiz yourself using Anki’s spaced-repetition algorithm. Since anatomy is
all about visual recognition/spatial thinking, Anki is perfect for this
subject. It’s much better than staring at a picture in a textbook until you
think you have it, only to forget it a week later.
As far as
studying for the test – and anatomy in general – goes, I really didn’t spend
much time in lab. I generally attended lecture, which I found to be helpful,
and then came home and made Anki cards for what we learned that day from
lecture slides, Thieme’s Atlas of Anatomy
(which has some beautiful pictures), our online dissector (which has a lot of the
Thieme pictures), or one of the Lippincott Concise
Illustrated Anatomy books (which comes with an access code for on online
version of the book on a great e-book platform – awesome for making cards). Also,
before or shortly after starting a new region of the body, I tried to watch the
relevant Acland’s Anatomy videos –
these videos are beautiful prosections of very well-preserved cadavers (which
are much more helpful, in my opinion, for understanding what the structures
actually look like than studying from a dried-up cadaver).
Those are my
primary study sources. I may occasionally glance through BRS Gross Anatomy or
play around with this awesome (and free) 3D anatomy visualization website – one of the reasons it’s so great
is that you can actually dissect away certain structures, which is awesome for
getting a handle on three-dimensional relationships of otherwise
hard-to-visualize structures.
One of the many
things I like about Anki is that, in the days leading up to the test, I wasn’t
spending time learning stuff. I already knew (or at least had seen) the
structures we needed to know, because I had been reviewing them according to
the spaced repetition algorithm on a daily basis. Instead, I was able to spend
time doing the relevant written and practical exams on the University of Michigan Medical School’s website,
which is an incredible (and, once again, free!) resource. It really helped tie
certain concepts together in clinical scenarios, while at the same time giving
me a rough idea of what the online practical format would be like (although, some of the pictures were rather
frustratingly unclear…). I did make an effort to do a passive once-over my
lecture notes, just to have one last integrated exposure to all of the material
and also to review anything that I hadn’t deemed worthy of “Anki-fying.” Finally,
I also reviewed any relevant sections of Rohen's Color Atlas of Anatomy to get an idea of what the beautiful illustrated pictures in Thieme and
Lippincott actually look like in “real life.”
It was only
the day before the test that I actually went down into the lab, which marks the
second time I’ve been down there since anatomy started a few weeks ago (the
first time was the dedication ceremony for the cadavers). While it can be
enlightening to see first-hand what certain structures look like and how they
interact with other structures, what you’re looking at in lab is not the best representation
of what things look like in real life (Acland’s videos do a much better job, I
think). Nevertheless, the anatomy lab is somewhat a rite of passage for medical
students, and besides, these are the cadavers that most of the pictures for the
practical are coming from. I spent maybe three or four hours in lab, reviewing
stuff with other students as we quizzed each other. Some fourth years are also
participating in the course as part of a fourth-year anatomy elective and also
gave some great mini-reviews. Finally, we have what our professor calls “Magic
Pens” (no idea what they are actually called) that are essentially electronic
pens with speakers in them. You can tag a body part with a special tag, and the
pen will read the tag and play back a recording of whatever the professor
wanted to record about that body part. These were helpful for solo-review,
since it can otherwise be frustrating trying to pick out various muscles,
arteries, and nerves out of something that, a few weeks into the course, looks
less like a human being and more like road kill.
One of the
biggest challenges of anatomy is figuring out a study routine that works well
for you. Each student will learn differently. Another one of the big challenges
is sorting through the mountain of information presented to you, organizing it
in a way that makes sense, and memorizing it. I feel like the tools above help
me do that, and it seems to have paid off. I’ll continue using these resources
for the next test, and hopefully things will continue to go ok. We shall see.
Meanwhile, my dissection rotation is coming up – I get to do the thorax and
abdomen, which should be interesting.
We start on
Halloween – fitting, I suppose.
Labels:
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Friday, October 11, 2013
The Stare of Death
I’ve been on
fall break for the past week…and it’s been glorious. Loyola starts a little
early, but that translates into a week-long break halfway through the first
semester. Which is most excellent – and much needed. It’s been a long few
months. My wife and I have spent the break basically trying to be as non-productive as
possible (i.e. watching a ton of old movies that we watched as kids, eating ice
cream, and occasionally doing more big-person things like shopping, home repairs,
etc.). We’ve had a blast.
We also got to go to
our first ultrasound, which was awesome. My wife is twelve weeks along now, and he?/she? is starting to look like a little human
being. It was quite the moment when we got to see our child moving around,
kicking, and generally looking cute on the ultrasound screen. Just because I
can’t resist, here’s one of the pictures we were given to take home with (awww....). His/her feet kind of look like claws in this view, actually. But
they’re really quite normal – we checked. I may or may not have tried to count
his/her fingers.
But, alas,
break is soon going to be over, and back to the grind we go. We started anatomy
a few weeks ago. It’s actually been really interesting, but it’s also been
really, really busy. The tried-and-true fire hose analogy that people use to
describe the volume of information coming down the pipe at you in medical
school – all of which you have to know, and know well – continues to be proven
true, if not even more so than before.
Loyola
actually recently changed up their anatomy curriculum. Their overall goal was
to cut down on required time slogging through excess adipose tissue in the lab
and increase the time that students had to master the material on their own.
Personally, I’m a fan of that goal. Dissection is an awesome experience, and
somewhat of a rite of passage for doctors-in-training, but it can nevertheless
be somewhat of a drain on one’s limited amount of time. So, instead of having
close to twenty bodies for the class and everyone in the lab at once with only
a few instructors to go around, they’ve cut the body number down to six, posted
a faculty member at each table, and split the class up into rotations, with
each rotation dissecting a certain region of the body. I was assigned to the
thorax and abdomen, which should be interesting. Students can, by the way, go
down whenever they want, but only absolutely have to be there during their
rotation. Additionally, instead of making us sit in lecture, they’ve tried to
summarize the key points of lectures in short-ish videos that we’re supposed to
watch before coming to class (which, during anatomy, only goes for about an
hour or two max – which has been awesome). During class, the idea was that we’d
go over board-style questions that made us really think through the relevant
material to arrive at an answer.
There have
been a few glitches in the execution of their new curriculum, however. The
biggest issue has been with the videos and “lectures.” Unfortunately, trying to
pare down anatomy to a few “key points” leaves a lot missing. It’s difficult to
then go forth and memorize crap when we really don’t know where to stop – we
could, of course, go on memorizing forever (and,
being the neurotic medical students that we all are, we would). We really
didn’t know where to stop. Additionally, we were supposed to watch these videos
the “night before” the “questions lecture,” which really gives us no time to
process and learn the information…which means that the lectures really turned
into a waste of time, since we had no idea what we were supposed to be doing.
Finally, some people weren’t happy about the change in lab setup – I remember
one of the questions that always seemed to come up in tours of the schools on
interview day was something along the lines of “What’s your student-to-body
ratio?” (As an aside…this really isn’t
all that important. Really.)
Thankfully,
Loyola is pretty responsive to its students. We had a Dean’s forum, where we
basically were given free food and were able to ask the Dean of the school any
questions that we had. Anatomy was a hot topic. We all expressed some of the
above concerns, and within a few days we started to see some changes. First,
the “question lectures” became more “lecture-ish.” This was actually the most
helpful change, in my opinion, as it’s nice to have someone walk you through
certain things that don’t come as easily from a short video or staring at a textbook.
Next, the professor produced a more definite list of what we should focus on.
Finally, for those students who wanted more lab time, the professor started
doing short, daily reviews in the lab of the previous day’s dissection, just so
we can see things on an actual human body instead of simply in pictures and to
save us the pain of going down on our own and trying to pick through things. So
far, I think things are shaping up for the better – we’ll see how things go.
I have had a
few opportunities to get out of the classroom, though. One of the things I did
was volunteer at a free clinic in Chicago that Loyola students basically take
over for one night a week. First year medical students essentially observe,
might take a history, and pretend to listen to heart and lung sounds. Second
year medical students, on the other hand, really get to run the show – they’ll
interview the patient, examine them, come up with a plan of treatment, present
the case to an attending, talk it through with them, and write a note. It’s
really a great opportunity to get out of class and use some of the skills we
are learning. So far, first years have only covered the patient interview and
spent some time interviewing standardized patients, but as the year progresses
we’ll learn more physical exam skills. That should be fun, and the clinic
should be a great place to practice and take a break from class.
Loyola’s
anesthesiology interest group also has a
program called APEP, or Anesthesiology Preceptorship Enrichment Program.
It’s essentially a program that pairs students up with an anesthesiologist
mentor with whom they meet once a month for a few hours during the
anesthesiologist’s shift and discuss some basic science concepts in the
operating room. It’s a great way to translate some of our bookwork to the real
world. I’ve met with my preceptor once so far, and had a great time. We talked
about different sedation methods, intubation, difficult airways – and there was
mention of a possible opportunity to intubate in the near future. That’d be
fun. The program isn’t just for students interested in anesthesiology. I
personally didn’t have a huge interest in it coming in to medical school, but I
do want to explore different specialties and see what’s out there. Also, it’s a
great opportunity to spend some time in the hospital and learn some practical
stuff that one might not get through a lecture.
Finally, I
was able to spend an afternoon shadowing an emergency physician. Since I worked
for a few years in or around an emergency department before medical school, and
this is the specialty I have had the most exposure to, it’s also the specialty
I’m most interested in at this point (supposedly,
I’m supposed to change my mind about this at least twelve-bazillion times in
the first couple years. Or so I’m told. I’m sure I probably will). It was a
good shift – it’s different being introduced as a medical student and getting
the opportunity to participate more in the patient’s care. As a scribe, I was
used to standing in the corner and writing
down what was going on. Now, I actually get play some small role, and that’s a
lot of fun.
About
halfway through the shift, we heard the EMS radio come on. Through the static,
we gathered that there was a full code about to come through the door. The
usual calm before the storm ensued – people began to prepare one of the trauma
rooms and gather around the stretcher, double-checking their equipment and
wrestling their uncooperative gloves onto their hands. Then the double doors to
the ED flew open and a stretcher came through. It was being guided by two
people with another person trying their best to continue chest compressions
while walking alongside the stretcher. I didn’t catch most of the story,
although it didn’t sound like there was much of one – male in his mid-sixties,
found down. CPR started at the scene, epinephrine given just outside the ED
doors, no response.
The doctor I
was shadowing didn’t have this patient, but followed the stretcher into the
room to see if the other doctor on wanted a hand. My scribe instincts kicked
in, and I started to look for a corner to stand in and stay out of the way.
Before I found one, though, she motioned me to follow her in and threw me a
pair of gloves. The poor soul who had walked in beside the stretcher doing
compressions had been relieved by fourth year medical student who was rotating
through the ED, but he was starting to look a bit fatigued. Before I knew it, I
was standing over a very dead-looking patient, bouncing up and down on his
chest, and trying to keep time to “Stayin’Alive” in my head.
This was my
first time doing CPR on a real person. The first thing that struck me was how
everything seemed to slow down a bit. There was plenty of time to think. The
second thing that struck me was how grey the fellow looked. After that, I was
surprised by how “rubbery” his chest felt – somehow, I didn’t expect the rib
cage to have that much rebound. Finally, I quickly started thinking that I
really should do more cardio – compressions are exhausting!
The doctors
did a great job of making it a teaching experience. They showed me and the
other students where to check for a pulse to make sure that the compressions
are effective, and after using ultrasound to check for cardiac activity, walked
us through what they were looking for and what showed up on the ultrasound. It
was really interesting. They also made sure I saw the “fixed and dilated
pupils” – the stare of death. That was…weird. It really was a truly empty gaze.
With cadavers, their eyes are usually closed. It was different staring into
the eyes of a person who, moments ago, might have been thinking about what they
were going to eat for dinner that night.
The gentleman
didn’t make it. Or, more correctly, he stayed dead. And life went on. We went
and saw another patient, the body was prepared for viewing, and…that was it. I
had seen people die before, but this was the first time I had really been
involved in their care. That said, it really wasn’t sad so much as it was more of a profound
moment. I wonder if that feeling will stick around.
Medical
school continues to be a blast. This week off has been awesome, and I wish that
it didn’t end in a couple of days, but at least the material we are learning
is, I think, really interesting and fairly relevant to our future careers. So,
back to the grind we go.
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