First Jab

It’s been over two months since the rosy glow of orientation week, which seems like a distant memory. Winter has begun to settle on Westdale, and my morning walk to McMaster has become much brisker as the temperature has plummeted. But more than the weather has changed. I’ve moved from being absorbed in medical books and lectures to actually being at the bedside with patients. To put it more colloquially: “Shit's gotten real.”

I’ve been assigned to shadow a family doctor in another city for the next 6 weeks. He is an incredibly efficient and organized individual, with dozens of patients shuttling in and out of his office every day. 

He explained to me that he believes in throwing in students head first – letting them learn by struggling and making mistakes. In the first appointment, a large, amiable man bounded into the office, needing his blood checked.

“Is it OK if my student takes your blood today?” asked the doctor (he collects blood samples himself). This came as a surprise to me.

“Ummm, yeah. Yeah that would be fine,” said the patient hesitantly. I could tell that the man was enthusiastic about helping a student learn but wasn’t sure if he wanted to be at the other end of the needle when said learning actually took place. But he gave consent and seated himself on the examination table.

I uncapped a fat syringe, tied a band around his upper arm and watched as a vein emerged from his skin like a green submarine. I would have to go in at just the correct angle.

The doctor sensed my hesitation. “Jab it in,” he said sternly. The patient looked mildly terrified. I’m sure he was wondering: What if he misses? I was wondering the same. As I held the needle over his arm, I looked up and saw his big blue, puppy eyes looking back. You still want to help me learn, buddy?

I forced myself to stop over thinking. I slid the syringe easily through the first layer of fat and then felt it “pop” through the vein’s wall.

“Ow!” said the patient unhappily. Oops, I had gone too far.

“Draw back,” said the doctor. “Now… put in the first collection vial.” If the needle had gone in properly, blood would flow in. If not, we’d have to take it out and try again.

I gently picked up a vial and pressed it into the syringe. Thankfully, reddish-black blood gushed in, filling the vial in seconds. The patient sighed and relaxed as I filled another four vials. I went to the backroom and centrifuged the samples as the patient and doctor chatted about politics.

Practice. Whether you’re in professional school, a trade or at McDonald’s, you have to practice and practice a skill countless times to master it. Unfortunately, every medical student has his first injection, first lumbar puncture and first surgical incision, and a (possibly) terrified patient at the other end. Sure, we may have the chance to practice on rubber arms, but no synthetic device can ever fully mimic the human form. We must eventually try our skills on a live patient, and just hope that enough patients will be willing to risk extra pain from a student’s unsteady hand in order to advance the cause of medical learning.

We spent the rest of the day encountering a vast range of health problems, and getting to explore the human stories behind them. I took blood several more times, talked to an elderly man about his feelings of loneliness and comforted a girl with enlarged tonsils. It was refreshing to be immersed in the nitty gritties of clinical practice. While endless textbooks and lectures suck out your soul, seeing patients in real life leaves you feeling alive and connected.