One of the most distinctive aspects of a medical career is the vulnerability we see in essential strangers almost immediately upon introduction. Even without a medical degree, the third-year medical student will find out intimate details of one’s life while taking a history.
Patients will reveal their fears of a disease, embarrassing side effects of a new drug, a habit they are ashamed of. Halfway into third year, I have learned the personal details of other’s lives, even if heard through a case discussion, can be heavy to hear. I have sat in disbelief, completely struck by some of the things I have been exposed to.
The first death was difficult. Family meetings about posttraumatic stress disorder were hard to fathom. Standing outside a room, unable to truly participate as a medical student only thinking “please don’t die, please don’t die” was an experience no amount of preclinical patient-physician communication classes could have prepared me for. What is truly the hardest to believe, is after these moments, more intense than most I have experienced in my life, it was immediately time to continue rounds, go into the OR, follow up on some paperwork.
In recent weeks, I have finally realized these aren’t incredibly unique or difficult days: these moments are simply another part of medicine. Still, they provide occasional unsolicited moments of clarity. Listening to an oncology patient discuss her priorities while deciding treatment options triggered a deep longing for my own family, but also a certainty that I was in the right place: that I was willing to hear her concerns, and try my best to understand the turmoil of such decisions. While my role in the situation was only observing, I was grateful that I would one day have the opportunity for patients to open up to me and help them navigate through confusing treatment options.
Recently, while walking out of the hospital, I felt such excitement that I can do this with my life. I then realized how before medical school, I thought every day would be filled with that feeling. Social media is overflowing with articles on physician burnout, high rates of suicide and depression, a broken system, and the burden of medical school debt. It is no wonder how quickly a medical student can begin to feel the weight of such concerns.
A recent clerkship required a different type of final assignment: Write an essay on what we would do differently if we were going to die in ten years. My answer was natural upon reflection of the recent moment of excitement I had leaving the hospital. It brought me to tears that throughout the early mornings, exam stress, fear that I will hurt someone, I can still be overcome with a gratefulness that I am in medicine. Because of those feelings, the ultimate, albeit rare moments of clarity that I am in the right place, or at least on the right road to get there, I do not feel I would live my life drastically differently if I knew I was going to die in 10 years.
Emily Kivlehan is a medical student.
