How Medical Education is Traumatic (and Life Saving)

I was going through my old emails, and I came across the personal statement that I wrote to get into medical school. It has been five years since, and I can confirm that being a medical mud-blood (my parents are not doctors), I came in with very idealistic views. When my family was driving to drop me off at university, the song 'Show Yourself' from Frozen 2, was playing. I was cinematically looking through the window from the back seat, as Idina Menzel sang, "I'm here for a reason... Could it be the reason I was born?" If you don't know the song, please listen to it so you can picture just how pathetic I was. Jokes aside, despite all the anguish, choosing to study medicine was the best decision of my life.

Emotional Numbing

On the fourth day of medical school, we were thrown into a room with cadavers. We were told that the cadaver in front of us was our first patient, and we eventually learnt to cut into them. During my time in medical school, I've held a person's brain in the palm of my hands, I have seen someone take their first and last breaths in the same hour, I have held a patient's hand when they were grieving the loss of a limb. There is no other way to put it, the study and the practice of medicine are traumatic.

A lot of doctors who authored books on the trade have claimed that medical students achieve an 'assault to their sensibilities' throughout their career, a rite of passage that begins in medical school. It's psychological self-defence, protecting the doctor and the patient to a certain extent. It helps the doctor to adopt a rational behaviour when treating patients. I learnt how valuable this is whilst watching 'Sherlock'. When Dr Watson asks Sherlock to understand that a woman could die if he doesn't solve the case, Sherlock replies "This hospital’s full of people dying, Doctor. Why don’t you go and cry by their bedside and see what good it does them?"

Last year, I saw myself become less receptive to pain. My mother was complaining of having leg pain after going to the gym. Earlier that week, I saw a patient after he had an amputation done. I mentioned that to her and I immediately felt embarrassed. It might not seem very significant to some, but that statement that I made in response to my mum's pain meant that I was belittling her troubles.

In my personal statement, I mentioned that I aimed to have empathy without investing emotionally in patients. It is no longer one of my aims. I'd rather know what the patient is going through, so I know just what it is that I am fighting for. I'd rather know the value of a human life, I'd rather know loss and the pain that comes with it so I mean it in the future when I tell myself and others that I am going to do everything that I can. In a way, since starting this website, writing from the patient's perspective has helped me with that. I want to fully appreciate the front-row seat that I get to witness people's stories.

Intense Pressure

I asked to attend an emergency caesarean section for a twin pregnancy. It was a complicated case, and there were already four surgeons so I couldn't scrub in. Everything was routine. Until it wasn't. Baby 1 wasn't breathing. He was turning blue and was not wailing like his twin. The neonatology consultants were paged, and I was standing there like a waste of space. Until I wasn't. Baby 2's O2 saturation was dropping and they needed all hands on deck. I didn't do much but I held the oxygen mask in place for Baby 1. I stroked the baby's head with my little finger and I kept whispering under my surgical mask, "Please breathe." I must have whispered it around 50 times until the baby stabilised. Certainly, not every day is like this. But that day, I saw the whole team in that operation theatre focus like no other, for that one common goal.

It is literally life or death. That day could have easily switched from being the best to the worst day of the parents' lives. Mistakes are not welcome in this situation. In any other job, I assume, the worst outcome of a mistake is getting fired. In healthcare, it is someone losing their life.

Whilst I like the content and I like studying, the sheer volume of what I need to know scares me. There has never been an exam in medical school before which I could say, "I have revised everything." The pressure is understandable, we're not studying to pass the exam, we're studying because one day, that knowledge might be the only thing between a patient and their grave.

Amidst all this, the one solace is the camaraderie. Medical school breeds close friendships. We study together, stay awake all night together, cry together, party together and we're there for each other. Shared trauma brings people together.

Understanding Mortality

I remember this one class in my first year when they were teaching us about breast cancer. It was a class of ten, and everyone seemed very knowledgeable. They were talking about statistics, prognosis and mortality. I immediately thought about all the women in my family. I started sweating and my heart was pounding. I was looking at everyone and I couldn't fathom how everyone was behaving so utterly normal.

When we learn about medical conditions, we also learn the epidemiology and prevalence of the disease in the population. In the UK, the risk of developing breast cancer in women is 15%, over 113,000 individuals suffer a stroke each year, and up to 1/2 of the population could be affected by chronic pain. If you add to this the prevalence of every known and unknown medical condition, the odds of anyone being 'perfectly healthy' for a long time is negligible.

Studying medicine made me realise that there are two types of people on earth- doctors and patients. One might even have a dual role.

With the risk of sounding cliche, I've still got to admit. Understanding mortality, has taught me the value of the current moment. I am acutely aware of the fact that everything will change, and this helps me to cherish the normalcy that we often take for granted.

Conclusion

I now classify the period of my life before the university drop-off as 'Before Med-school' or BM, for short. I reserve the right to change the views that I have documented above. My experience will alter me, for better or for worse. A lot has happened since I wrote my personal statement. I have even wanted to quit a few times. But my default setting is always loving everything that comes with medicine. I am excited about what lies ahead.