M3, a wrap

As quickly as it started, it ended.  Just one year ago, when the PhD concluded, I briskly, and wildly underprepared, ventured back into the clinical world of medicine as an M3.  My "doctor" title, granted from the PhD was as meaningful as the points from "Whose line is it Anyway" in this new foreign territory.  My expertise with animal surgeries and operating various different imaging apparatuses refined by years of lab work poorly translated to better history taking or physical exam skills.  To call me petrified was an understatement during this metamorphesis. Thanks to the calm patience from several attendings and understanding residents, I soon started to grasp the modus operondi of the clinic.  By the end of the year, I was comfortable managing numerous patients with multiple co-morbidities on an inpatient floor simultaneously.

Medical school is a terribly wild and unruly roller coaster ride of experiences and emotions.  Generally, our residents and attendings embraced a "mother-bear" protective attitude towards us students, not allowing us to take some of the more callous patients or those with poor terminal diagnoses.  The worst experience for me  was having to inform a patient that his headaches and shortness of breath / cough were likely caused by lung cancer that had metastasized to the brain.  Nothing in my training could have prepared me for that.  Another particularly lugubrious experience was being the student who received and transferred a grossly premature baby from the obstetrics team to the NICU team.  It was smaller than the palm of my hand when I received it and I still do not know how that baby faired out.  Lastly, and not unique to any specific patient, but too frequently did we encounter inappropriate discharges for patients that were unable to receive the drug rehabilitation they requested or the physical/occupational therapy needed to restore their health, due to insurance denials.  Insurance companies dictating medical decision making is utterly inappropriate and detrimental to patients' wellbeing.

For the most part, the 3rd year was filled with heartwarming experiences more freqeuntly than the negative troughs.  The greatest highlight of the year came when I actually skipped clinic to meet up with an old MDA camping buddy of mine to receive the first ever commercially approved treatment for Duchenne Muscular Dystrophy. Another highlight during surgery was helping drill burr holes into skulls, assisting with Deep Brain Stimulation surgery (under very watchful scrutinizing eyes). Naturally, delivery babies during the OB-GYN clerkship synthesized unforgettable memories as well.  One particular experience that was rewarding was when I had the opportunity to take care of a mother who was having pregnancy complications, and then several months later, saw the family with a +1 in tow in the pediatric ED.  The family happy-cried seeing me take care of their baby (who turned out to be just fine)! Lastly, many tears were shed with several families whose lives were turned upside down because of diagnoses to their children.  While these situations certainly can be seen through negative lights, we made sure that the families and children knew that we were all on the same page with them, whether it was to provide the highest remaining quality of life possible and helping them leave legacies, or to help guide them through difficult chemotherapies seeking remission of the diseases.  The final positive experiences that we had was to help plan for "good" deaths with palliative medicine and hospice for terminally ill patients and their families.

In all, I cannot believe the year is over.  I still do not know how I survived the sleep deprived surgery residents and attendings, to the interminable rounds of medicine.  Through it all, my patients were the best teachers that I had, allowing me intimately into their lives during their most fragile and vulnerable times.  It's a sacred communion that few other occupations have the privilege to experience.  Moving forward, I've assisted with surgeries that I'll never again perform; I'm not planning to ever deliver another baby again; and I'll never have to spend hours as a statue battling accumulating lactic acid in my weakened muscles and increasingly distressed detrusor muscles retracting bladders during multi-hour surgeries, but would I trade it for anything? No. It was the opportunity of a lifetime composed of unexpected daily adventures with people that I'll never forget.