During my second year in medical school, I wrote an email to the rheumatologist with whom I spent some time during M1 year. I told her how I would more easily remember the insignificant, non-medical trivialities from my lectures rather than the testable, high yield, board-relevant material that I was spending so much time just trying to care about at times--let alone learn.
Today, as I prepare for boards, I find myself in a similar situation: fighting the urge to gloss over certain diseases, risk factors, etiologies of conditions that at times mean very little to me. Every so often I'll come across a condition that links to a friend I have, a patient I saw, or an encounter in the hospital. Myasthenia Gravis, Essential Tremors, Multiple Sclerosis are replaced with the faces of the friends and people who have played an instrumental and meaningful part in my life these last few years. For a brief moment, they become my daydream, my escape, an absence seizure from the world of medical terminology.
If you asked me about acute pancreatitis, I could not tell you Ranson's Criteria but I can tell you all about the homeless man that had it--how he was a boxer in his youth, could control his blood pressure with his mind, and how he would roam the streets at night living a life that you would only see in movies. If you were then to ask me about Meckel's Diverticulum, I could not tell you the specificity of scan to detect it (the sensitivity yes!), but I could tell you all about the anguish and cultural intricacies written all over the a Chinese mother’s face as she couldn't understand why the surgeons had performed the surgery on her son when there was no Meckel's to be found in the OR.
And so this is how it has been for much of the last year; it has seemed to me more of an experience than an education. I ask myself what exactly I did this year outside of accumulating a treasure chest of stories that I might one day dig out for the sake of good conversation.
Furthermore, in the back of my mind, I am terrified that this will not be enough--that these ruminations will be woefully inadequate for me to master the information I need to effectively convey to my future patients. I ask myself whether these reveries are but an expression of laziness that serve to convince me that I really am engaged with the material.
Having said all this I return to my letter to the rheumatologist. In her reply to me she wrote the following.
"I was always of the opinion that recall of all those meaningless trivial facts was the sure sign of a bright and inquisitive mind, one that had room for lots of stuff, not all of which came from books! I think it also means you recognize the humanity in us all, a good trait for a doctor to have! It helps to reinforce the concept that we take care of people, not just diseases, and that humanity thing is what keeps medicine interesting and relevant."
Looking back at her words, I take hope in the larger picture. For I am neither naive enough to believe that a better academic performance would have proved a greater personal dedication to my craft nor am I delusional enough to think that every mistake I've made is simply a product of a bright and inquisitive mind emerging from the chaos that is medical education.
The reason why I got into this was because of the people I met along the way. As much as I conceptualized what medicine should look like, the only reason why I am still in school is because of the people who showed me what medicine could look like. In the end, the latter is what I have to hold on to for now. With each new experience stones will shift, clouds will clear, and visions will change. That is to be expected.
For now, the words of my high school Spanish teacher ring through and through
"Lo que sera, sera..."
