Two weeks ago, our medical school class received our white
coats in a fancy ceremony at the Hamilton Convention Centre. It felt
intimidating to walk up on stage in front of hundreds of people while one of
the faculty members helped you put on your coat – I struggled to get mine on. Because
McMaster has the second largest medical class in Ontario, we had to wait for
over 200 students to walk across the stage. Afterwards we all headed into the
main hall for refreshments and pictures.
To be honest, I feel a little pretentious wearing this white
coat. I have never made a diagnosis, taken blood or even given a shot. And so
it was a welcome relief a couple days later to shadow an internal medicine
specialist in the Emergency Room of a local hospital. We stayed primarily in an
area for patients (mostly very sick and elderly) being assessed for admission into
long-term care. During my visit, the doctor focused mainly on an elderly man suffering
from a severe infection and the beginnings of dementia. I, and a fellow classmate,
performed basic cardiac and respiratory exams and helped hold the man as the
doctor performed a rectal exam.
Here, the painful realities of medicine – of suffering and
death – contrasted sharply with the glamor of the White Coat Ceremony. The old
man we saw just wanted to be home with his wife, but he recognized that his
body was failing and that he needed to be in hospital. I was surprised at how
cheerfully he behaved, even though he was in a lot of pain and trapped in his
hospital bed 24/7. He even told us a few snippets about his time fighting in World War II.
It was chilling to think about how this man was once strong
enough to fight in a war, but was now extremely vulnerable and weak. When we asked him if
we could perform certain exams, he always said, “Do whatever you want to do.”
Clearly, he completely trusted his healthcare providers to protect and care for
him in his final lap of life. I felt a need to do every thing that I could do
(which is not much as a student) to make him feel comfortable. This was not just
out a sense of caring, but also because I could imagine myself lying in that
hospital bed one day, aged and sick.
The next day (Friday), hundreds of medical students from
across Ontario descended on the Radisson Hotel in Sudbury for the annual Ontario
Medical Students Weekend. I was expecting it to be an intense two days of
skills training, but it turned out to be mostly a giant frat party. By 11 pm,
the hotel was full of drunk med students being intermittently yelled at by the
security guards for bringing alcohol into the hallways. At 2 am, a student
pulled the fire alarm as a prank, and everyone in the hotel had to evacuate.
Then the alarm was pulled again.
All of us exhausted, we began skills workshops the next
morning. I learned how to suture using artificial, rubberized skin followed by a
session on IV injection. The conference organizers provided us with these
incredible rubber arms that had their own veins and a working system of blood
supply. We learned how to find a “juicy” vein and inject the needle at the
proper angle.
Since returning from the thrill and exhaustion of that weekend, I’ve buried myself in studying the heart’s conduction system, the current focus of our curriculum. I even went into the lab a couple days ago and held a few prosected hearts in my hand. Not to mention spending hours learning obscure cardiac medical terminology.
But I’ve realized that all this terminology, the white coat,
the ceremonies – all pale in comparison to the value of connecting with the
patient. While shadowing the internist, I had checked the heart rate of the
elderly man. Placing my fingers over the bottom of his wrist, I felt his warm
skin and a gentle pulse. I could sense the patient looking at me, and I felt a
sense of deep appreciation from him. That sense of appreciation was more real than any ceremony could ever be.
