To say the second year of medical school is a modification of the first is an understatement. From books to suites, from floppy days to strict routines, the transformation is stark.
Dukes are somewhat special in this regard. Many medical schools wait until their third year to throw their students into the wards, allowing two years of classroom learning to suck and slip. But Duke, in a pattern many of its peer institutions have followed, began sending sophomores to the hospital for office work decades ago. Honestly, that’s one of the main reasons I applied here. Do you sit in a classroom and listen to people using drones about the cell cycle? No thank you. Saving lives, having children, and attuning to a mysterious diagnosis that turns out to be true? Involve me.
But all those pleasing photos that prove attractive during applications can conflict with the conflicting transition between the first two years. The idea of being in the hospital so quickly into your career sounds great until you’ve finished your first year and still feel woefully unprepared. But if life is about anything, it’s about unfortunately not preparing in as graceful a fashion as possible.
So this was the position I entered into my first cycle, surgery. Known for its early mornings and long hours, the surgery requires an alarm at 4:00 a.m. for several days to head in with time to change to the brand’s surgical green scrubs.
As a morning person, I find it fascinating to watch the world wake up. While hiking the deserted Irwin Road after reading an article about a Memphis jogger who was kidnapped early in the morning, I sometimes wonder if I should buy a parking permit. But those fears faded when I was greeted by the warm glow of the lights of Irwin’s toughest rivals, ExxonMobil and BP gas stations abutting the Research Drive junction. On particularly lucky days, gas prices are sometimes different. This is extremely rare for me, and I make sure to take a photo to document what looks like a forbidden peek behind the curtain.
Finally, I got to the hospital. There isn’t usually much activity at 5am, but within an hour the halls are buzzing with noise as the day shift begins to arrive and the night teams prepare to leave. When we’re done rotating, a glimpse of the outside sometimes reveals that the sun is crowning the horizon; Other times, it gets dark. In today’s hustle and bustle, it can sometimes be easy to lose time and forget that there is a whole world out there.
The hospital itself is like a culture of its own, with new habits to be learned. There’s an electronic medical record system to technically master, a whole new set of acronyms and terms to adopt, and procedures to follow.
When you don’t know anything, it’s often tempting to pretend you know everything. Walking into the operating room and admitting you’ve never cleaned it before seems awkward, but if my first two weeks in the wards taught me anything, most people would love to feel helped. There is no need to pretend you know how to do something and make a mistake, I learned, especially when there are so many people around you who have done the same thing thousands of times. Balancing the humility of asking for help with confidence in one’s knowledge to move forward without help seems to be one of the most important aspects of medicine.
Being a second-year medical student in a hospital constantly makes you realize that you are at the bottom of the food chain. Behind this cadre of treating physicians, fellows, senior residents, interns and fourth-year medical students, you faithfully follow orders and try to get involved when you can. This knowledge comes with the realization that you have worked for many years to get to where you are, but you still have a lot to go with.
Watching the surgeon and other senior members of the team skillfully maneuver the instruments during the procedure can make you wonder what value they really add. A second-year medical student’s job during surgery generally involves operating the camera, holding retractors to help the surgeon see the area he’s working on or helping to sew up the incisions at the end of the procedure.
What I’m starting to realize is that the medical student’s role on the team – at least in the surgery course – is not so much technical as it is human. Students alone won’t perform a life-saving procedure, but we have the most time to actually interact with patients when other team members get stuck on other tasks. We serve as new faces to push senior practitioners to rethink their assumption or remind them of their younger selves. It is an honor to occupy this role.
Nathan Luzom is a sophomore medical student and a member of the DSPC Board of Directors. His column runs on Wednesdays alternately.
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