Last month, thousands of medical students donned their white coats as they took their first steps into hospitals nationwide to begin clinical rotations. This marks an important transition from the classroom into an actual inpatient setting to demonstrate the knowledge they’ve accumulated over the past two years. For most students, this means pretending to hear and correctly identify heart and breath sounds while agreeing with whatever the attending says. During my brief time on the floors, I’ve not only learned a great deal of medically relevant information, but also things that weren’t advertised to me when I was a student.

1. Nurses go criminally underappreciated. Despite all the chaos that goes on in the hospital, nurses are continually monitoring and managing their patients around the clock. They are truly the worker bees of the hospital, fulfilling endless orders from the residents and attendings. Just last week, I observed a nurse clean up an elderly patient without hesitation after they defecated and urinated on the floor to show their displeasure with the hospital. Medicine is a team sport, and the nurses are integral members.

2. Nothing makes us feel more guilty than waking a patient up from a deep sleep. I’ve had to deal with my fair share of Jewish guilt growing up, but never have I felt worse than when I am tasked with finding out something inconsequential like if my patient has any allergies to squid tentacles while they’re passed out. My options are risk disappointing my superiors or get looks of “really, idiot?” from my patients after waking them. Since my superiors write my evaluations that determine the rest of my future, I just have to find a way to deal with the incessant guilt.

3. A great deal of hospitalizations are preventable. Only being in the hospital for a short time, I was surprised to see how many admissions are due to medication non-compliance or bad habits that patients refuse to give up. Smoking and obesity are rampant in this country and drive up the cost of health care. I recently listened to a very inspiring speech about smoking cessation my attending gave to a lifetime smoker after he got admitted for a heart attack to which the patient wholeheartedly agreed with while walking outside to go smoke again.

4. The lower the education level of the doctor, the more attention the patient gets. Depending on the hospital, an attending oversees about 30 patients, while a resident oversees about 20 patients, while an intern oversees about 10 patients, while a medical student oversees about 1 to 2 patients. Although patients are weary of interacting with medical students, the truth is we have the most time to spend with and really care for them.

5. Doctors have awful handwriting. All the stereotypes about physicians having the worst handwriting are absolutely true. I’m tasked daily with trying to decipher what chicken scratch a consult wrote from the day prior for a patient I need to present. Hospitals are beginning to transfer over to electronic health records which is crucial in preventing medical errors through potential miscommunication.

6. Nobody knows how to correctly pronounce medication names. My favorite part of the day is morning rounds when residents and medical students including myself present patients to the attending while quickly mumbling over difficult medication names in hopes they don’t ask us to repeat it. Usually just saying the last syllable suffices as long as the dose makes sense. Needless to say, the pharmacy department hates us.

7. Free food creates chaos. Like clockwork, the hospital supplies the medical staff with lunch after 12 p.m. conference every day. The second the conference ends, everybody pushes and shoves through the auditorium doors to get to the tables the food rests on. It’s at this point where everyone forgets how to form lines, and a bunch of hands reach towards the plates like zombies rising from the ground. The stragglers are left with scraps and empty stomachs. Survival of the fittest.

8. There are too many medical abbreviations. Since hospitals are so busy, there’s an abbreviation for just about everything medical these days. On one of my first days, while trying to interpret someone’s emergency room admission note, the physician detailed the patient with having “AMS,” something I’ve never heard of before. With the help of Google, I quickly learned it stood for atypical measles syndrome which I presented to my attending. Luckily, someone far more intelligent quickly corrected me that it meant Altered Mental Status. Bottom line: there are too many abbreviations that cause confusion, especially for fools like me.

9. Medical documentation takes up most of the day. In this day and age where everything needs to be documented, writing medical progress notes, consults, and orders takes up most of a physician’s time. Unfortunately, this leads to less time with the patient and more time in front of the computer. I’m not sure if there’s a good solution to this problem, but something has got to change in the future.

10. Pursuing a medical career is worth it. Although cliché and moderately corny, there is something remarkable in seeing a patient go from near death to fully recovered. Medicine has advanced so much over the years that diagnoses that were once certain death sentences are now fully treatable. Finally getting to witness that firsthand after spending the past two years cooped up in a study room has made me appreciate medicine more than ever before. Throughout the long nights, endless loans, and insurmountable stress, I’ve never been happier in choosing this career path and am truly excited to see what’s in store for the future.

Brandon Jacobi is a medical student.

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