July 30, 2007

Color Me An Idiot

Big news today when supreme court chief justice John Roberts went down at his vacation home with a sudden unexpected seizure. Since I spent the first dozen years of my life really interested neurology, I checked up on the actual medical diagnosis of his condition.

Ruled: benign idiopathic seizure

Being the classically bored pre-medical student that I am, I bust out Stedman's Medical Dictionary to look up the proper definition of "idiopathic."

Denoting a disease of unknown cause. Less commonly referred to as idiopathetic.

Idiopathetic. Sometimes I love the english language. Only a term denoting an unanswerable question of diagnosis contains reference to both the words "idiot" and "pathetic."

July 26, 2007

My Shoulder Named Dr. Orthopod

It's that calm before the storm. Med school orientation starts in 18 days. I have a place to live and a bed to sleep in. I'm about as organized as I am going to be before the madness begins. I'm in a city at least hours away from mostly everyone from my regular social group. Which gives me a lot of time to do absolutely nothing. My time hasn't been this unoccupied in years and its given me a lot of time to reflect.

Medicine is one of the most paradoxical professions out there. Medical school self-selects for individuals who ooze empathy, a desire to do good and help others. That empathy is subsequently systematically destroyed under the notion that it is only by being objectively detached from those one treats that you can decide what is best for them. I keep wondering what kind of doctor I'm going to be. Am I going to be the type who will be able to look into the eyes of a patient and explain we've done all that we can but they will die and be able to connect on a level that I can actually continue to make a difference in their care beyond the point of drugs and tests? Or will I be the type to switch into a systematic "I'm sorry" routine, give the hands two squirts of sanitizer on the way out the door, then drop the chart into its wall mount and move on to "patient #2 is presenting with..." Only time will tell.

I think most medical school students still, despite all our hours of clinical experience, ER shadowing, and hospital volunteering, hold a great deal of naïtivity and delusions of grandeur about being a physician. And I think thats a good thing. Medicine is an issue of ultimate trust between patient and doctor. Doctors take ownership of their patients' bodies, and patients are oddly at ease with it. Just today at physical therapy, I referred to my shoulder as my orthopedic surgeon's "good work." Not my shoulder repaired by my orthopedic surgeon. My shoulder, property of my orthopedic surgeon. His sutures will dissolve in a few months. The anchoring screws in a few more. But it will ever be his handiwork. In a perhaps overly dramatic statement, if it weren't for him, a part of me would be broken, and now its fixed.

I think with that sort of responsibility the physician owes more to the patient then to be completely detached. And I think starting down the path to the doctor-I'm -going-to-be that its good to have some of those childhood visions about being a doctor, riding off on his horse into the sick and diseased and waving his staff of asclepius in the face of death (I know, I had a dorky childhood). Because I think too many doctors these days treat the disease and not the person. But I've seen enough physicians who are exceptions, who treat their patients kindly, humanely, empathetically, and intelligently, to know that it doesn't have to be like that. I know my medical school class can be 120 for 120 in producing empathetic, caring doctors. Odds are it will be much lower then that, because the culture of medicine is structured to beat that childhood pipe dream out of you - to emotionally protect you, to "make you a better doctor." But I think you need to have that childhood doctor-in-shining-armor inside you in the beginning, because you never know how long it will stick around or when it might pop up again. It might be at the end of a 48 hour shift when I'm an intern. It might be 7 years later as an attending. But the important thing is, you might just find yourself treating people again, instead of "patient #2 presenting with..."

I wonder what kind of doctor I'm going to be. I hope I'm one who treats sick people and not sickness.

And turn out looking like McDreamy. With the wit of Perry Cox. Yeah, that'll do just fine. But mainly the sick people part.

"Because it is particularly in cases of catastrophic or incurable illnesses that the role of the physician is more, not less, important, let me suggest that the fewer the therapeutic options available, the greater your involvement with the patient should be. When there is no cure, there is still much to be done to alleviate suffering."

July 25, 2007

Hi, my name is MedZag and I'm going to be a...

first year medical school student.

I've always loved telling stories. In my 21 years, I like to think I've collected a solid repertoire of anecdotes to fill my head during those boring moments (like, say, a night in a bar with eskimos). I've wanted to be a doctor since that day in 1991 when my mom bought me that Fischer Price doctors bag of instruments (which I still have - which happens to say a lot about me as a person). So I'm hoping this blog gets to be as much a chronicle of my personal journey through medical school for my own recollection years down the road as much as it an entertaining read for any of my friends sympathetic enough to read it as well. It might give a little insight to those of you who are curious into how our medical curriculum and training steal the humanity and soul out of our future doctors... and why this may be a good thing. It might just serve as a personal ego stroke to myself from time to time to remind myself that what I'm doing actually is pretty cool and that all the hours of personal isolation spent studying and the verbal abuse from the powers that be are worth it.

I've always loved telling stories. Hopefully you'll enjoy listening.