Six weeks ago, I made my official entry into hospital life. I put on my short white coat, stethoscope around my neck, and headed into Children’s Hospital Los Angeles, having no idea what to expect. My first week was also the interns’ first week, so I got to witness firsthand the impossible transition between being a medical student one week and a doctor the next. Spoiler: there was not a day when no interns cried.
The first thing that stood out to me was the incredibly intense work culture. I didn’t know that so many people could act like it is completely normal to work for 12 hours at a time without so much as a ten minute break. I arrived each day at 5:30 am, and when I’d get dismissed around 5 or 6 pm, the interns would look at me longingly and tell me to enjoy seeing the sun. There is no such thing as a lunch break. Everybody works furiously until 1:30 or 2 pm, then we go and grab food from the cafeteria and bring it upstairs, right back up to our work stations.
Every sixth day, I worked a 17-hour night shift. I felt very doctor-y, running around the hospital all night, admitting patients with my intern. For the patients I admitted, I was the first person to talk to them at length since they had arrived in the hospital, and I was the one waking them up every day before 6 in the morning to talk and examine them. When it came time for rounds at 9 am, I’d make a presentation to the medical team (nurse, three interns, senior resident, attending), patient, and patient’s parents. It was the first time I got to follow the same set of patients day after day.
At 3 am one crazy night, after holding down a particularly squirmy, screaming toddler to jam a tongue depressor and a flashlight in his mouth to look at his throat until he threw up on me (out of defeat or protest, who knows), I stepped into the hallway with my intern. She looked at me and said, “Why am I here right now? I love kids, but I could have made so many other choices and been happy. I could have been a teacher. I’m so tired. I hate my life.”
Perhaps that will be me in two years. I really think working every sixth night indefinitely, and working from 5 am until 9 pm on all the other days, with an average of one day off per week (which means you could get stuck working 12 days in a row), will kill me, too. I understand why there are so many tears. I’m sure I would have cried trying to do all the work they had to do every day, knowing that getting tired will only slow you down, so you won’t get to leave until late at night, but no matter what time you leave you have to get up at 4 am and come back so you can start over the next day.
Before this gets too dark, I want you to know that some parts of it are good. My psychological state is much better than it was two months ago. Working with people in the hospital is far less depressing than silently studying alone for 10 hours in my room all day. An overwhelming majority of the pediatricians I have worked with have been nothing but supportive and eager to teach. It just seems that as a group of people, doctors have taken it upon themselves to remove all non-essential elements of human interaction. Thus, because I am a third year medical student and my value to the medical team is extremely low by definition, my presence is often ignored completely. It’s not personal.
Being a third year medical student is the most awkward thing I’ve ever experienced. Janhavi used to tell me that when you’re a third year, you become very aware that third years drag down the hospital, and that it’s no one’s fault, but that it sucks for everyone. I don’t know how to do anything, so I always have to be shown. My notes need to be proofread, my patient plans modified, my physical exams double-checked. It’s a giant amount of work to teach an MSIII (medical student III: that’s my title now) to be a doctor.
After my three weeks of inpatient life at CHLA, I transitioned to outpatient clinic life at the county hospital. I have a much less active role in clinic, often just shadowing. Sometimes even being the shadow of a doctor is difficult. More than once I lagged behind the group by ten seconds, taking off my disposable gown, mask, and gloves while saying goodbye to the patient, only to step into the hallway and realize that the entire team of doctors had evaporated. Poof.
I have become very good at looking busy while standing idly in the middle of a hallway. I’ll be with a couple residents, waiting for the attending, and they’ll sit down at computer stations to write their patient notes. There are no extra chairs, and I can’t go study somewhere else because no one would think to come grab me, so I just stand by, trying not to hover but not to get ditched either. I tally the minutes of awkward loitering I have accumulated over the past few weeks.
There is a palpable hierarchy. As medical students, we are advised to only answer questions that are asked directly to us, even if a question is posed to a small group. You don’t want to come off as a know-it-all, or to make the residents look bad. Quizzing medical students is everyone’s favorite activity. It’s called pimping. It makes up a large part of the interaction I have with doctors throughout the day. It can be used to assess a baseline level of knowledge on a subject, or just for the general entertainment of the doctors. I was in a lecture the other day, in a small conference room with about 15 doctors. I was sitting on the floor next to a bookshelf, since it is an unspoken rule that medical students are the first category of people to sit on the floor when the chairs run out. Halfway through the lecture, the professor pointed to the bookshelf and said, “I saw a medical student back there somewhere. Medical student! What is the molecular weight of albumin? This should be common knowledge.” I don’t know.
Finding somewhere to sit is one of my most frequent problems. In bigger conferences, the designated area for medical students is at the very back of the ballroom. Even though I arrive early, I look at the empty 50 seats and realize that there won’t be one for me. I put my stuff down and go chair hunting. When I find one that looks stealable, I start the trek back to the conference room, carrying my chair. People stream steadily into the conference, 2 minutes late, 5 minutes late, 10 minutes late. I can feel someone hovering right behind my chair at 8:15. I turn around and ask the doctor if she’d like my seat. “Sure, thank you,” she says. So I sit on the floor in the back of the ballroom, leaning against the wall, unable to see well. I find this ironic since I am the one who knows the least out of anyone in attendance, and I am in desperate need of teaching. Even if I had carried ten more chairs to this meeting though, I’d still be sitting right here.