As I enter my fourth clinical rotation here at Geisel, I am beginning to notice a pattern of physical and mental occurrences that seem to come on at the dawn of each clerkship. My sleep is a bit restless as my mind struggles to suppress a new flurry of diagnoses and confusing hospital hallways. Katerina, my current roommate and fellow third year, can attest to the daily dishevelment of my blankets that bear the brunt of my nighttime thrashing. Even during the day, my shoulders feel tense and my forehead has a permanent furrow of puzzlement due to the overwhelming transition into what essentially feels like a new first day…except this is happening every six to eight weeks.
That’s both the beauty and the ugly truth of the clinical years of medical school – just as you find yourself in the groove of where to go, what to do, and which questions to ask (or never ask again), you are suddenly thrust into a new environment where you must start anew. So far, I have worked with adults and children; in private, public, and federal hospitals; 24-hour shifts and 7-hour shifts; loved some specialties and really disliked others. It’s essentially the opposite of that movie Groundhog Day – every day I wake up to find everything exactly the same different. The only consistent theme throughout these six months has been the love and support of my family and friends, and that is more than enough to keep my head clear and my shoes matching.
"I want to be tall and have a tie like that!” The first words out of my very first pediatrics patient. Given that I had spent a considerable amount of time deciding on that particular tie (more time than I care to admit on such a public forum), I welcomed this rather enthusiastic introduction to the world of pediatrics.
The five-year-old patient and his three-year-old brother were in the clinic for their regular checkup. Full of energy, bouncing off the walls, and touching all the instruments they could lay their little hands on, they answered all our questions in very loud matter of fact tones. “I wear a helmet when I ride my bike so I don’t get hurt!” The little one watched his older brother closely and tried to emulate his actions and speech, much to his brother’s chagrin. Their interactions reminded me of my older brother and me when we were around the same age (we’re separated by just over a year). Through all the proceedings, my preceptor was somehow able to obtain a very thorough physical exam and history. I watched as he jumped right into the fanfare, skillfully engaging the boys while simultaneously soliciting the necessary information.
Several hours later, our last patient of the day had arrived. We were seeing this child to give the go-ahead for an operation that would be performed the following week. As I was about to ask why a two-year-old would be receiving such a procedure, I was told the patient’s diagnosis. Mustering all the self control it took not to let my jaw drop, I dug deep into my memory bank, rattling off the many features of this rare syndrome. This disease carried a grim prognosis—very few kids survive past their first birthday.
Still in shock from the news, I followed my preceptor into the room, gearing up for a solemn visit. But the mood in the room could not have been further from my expectations. Instead of gloom, it was filled the room with excitement and joie de vivre.
The parents happily recounted the history of their child’s disease, going into great detail and offering to show me more upon discovering that I was a medical student. The mother at one point even whipped out her phone to show me pictures. Toward the end of the visit, perhaps sensing my bewilderment, she turned to me and offered a few words: “Our child has been more than a blessing to our family, and we try to treat each day as a gift.”
As I drove home, and replayed the days events in my head, I pondered on the contrast between how my day had begun and how it ended. Two rooms inhabited by very different people in very different situations, yet somehow with similar doses of enthusiasm and positive energy.
Inyang Udo-Inyang (’16) is a medical student at Geisel and a member of the Urban Health Scholars. He is originally from Lagos, Nigeria, and graduated from Oberlin College in 2012, where he majored in biochemistry. Read all posts by him here.
"How many of you have experienced moving to a new culture?” I sheepishly delayed raising my hand until I saw most of the hands in the room were up.
I was joined by 13 other classmates seated in one of the conference rooms at DHMC. The air in the room was filled with excitement and nervous energy. Today was our first day on surgery, our orientation. Fresh off our board exams, we would finally be on the front lines. Taking care of patients. The very thing we had come to medical school to do.
Dr. Andrew Crockett, co-director of the surgery clerkship was explaining what the next eight weeks were going to look like. “You are now joining a new culture, one where we speak a completely different language. One you are going to have to learn to speak.” Anyone who has had the unfortunate pleasure of learning a foreign language is all too familiar with the beginning painful phases of hand-waving and facial contortion that occur before becoming comfortable with said language. True to his analogy, my initial foray into surgery would be much like assimilating into a foreign culture.
I had been assigned to my first choice, the orthopaedic surgery department. On my first day, I walked into the operating room (OR) with an almost unhealthy amount of enthusiasm, primed to take on whatever task I was assigned, only to find that everyone and everything in the OR already had a very specific role. The OR was a well-oiled machine with seamlessly moving parts, and I stuck out like a sore thumb (no thanks to my 6’ 7” frame).
As most people eventually discover in the process of integrating into a new environment, the acceptance and guidance of the “locals" is essential to feeling comfortable in the new surroundings. That has certainly held true in my four-week journey in orthopaedics. The residents whom I got a chance to work and interact with have been unbelievable. They fashioned an inviting environment of support, teaching, and mentorship replete with extensive suturing sessions, World Cup games, evening barbecues, lessons on spondylolisthesis, and much more.
It would be very remiss of me not to mention the incredible amount of help and support I have received from the nurses, from guiding my wandering attempts touse a Foley catheter to helping untangle me from my OR gown (yes, it happened), they have been very gracious and kind.
In the meantime, I have become enthralled with the world of orthopaedics and eagerly await the next time I can submerse myself in this new culture. With these kinds of people in my new environment and a whole career ahead of me, I have no doubt I will settle into this environment just fine.
Inyang Udo-Inyang ('16) is a medical student at Geisel and a member of the Urban Health Scholars. He is originally from Lagos, Nigeria, and graduated from Oberlin College in 2012, where he majored in biochemistry. Read all posts by him here.
In the midst of my final week of the preclinical portion of medical school, I have found myself reflecting on days past, speculating on those to come, and eating—an activity not unique to this week, but always notable for me. These contemplations and consumptions have led me to the verdict that the standard American medical school experience can be compared to a typical three-course dinner.
First and second year: Salad
Whiny Kid: “Mom, do I have to eat the salad first? It’s just so…green.”
Loving Mother: “Yes, dear. Even though it may not be the tastiest thing on the table, it is very good for you and helps you digest the rest of the meal.”
Medical school professors of the basic sciences must be sick of hearing the same questions year after year: Will knowing this biochemical pathway help me heal patients? Is the life cycle of an immune cell appropriate bedside conversation? WHY DO WE NEED TO KNOW ALL OF THIS?
As I’ve come to realize throughout second year, although we may not apply much of this information explicitly in clinical work, I would be totally lost without the basics. I imagine that many of the scientific details we learn in the second year may be less applicable to my work one day, depending on the specialty I choose. Nevertheless, I will be grateful that someone had the insight to make me learn the details of many diseases from the molecular level all the way to what it looks like in the clinic. The salad is the least fun and takes the most effort to finish, but we all know it’s necessary.
Third year: Filet mignon, garlic mashed potatoes, and roasted asparagus
HELLO, GORGEOUS! I’ve paid my dues in the classroom and am at last being rewarded with hands-on clinical experiences. Instead of looking at PowerPoints, I’ll be looking at patients, attendings, operating rooms, and everything else that is the essence of health care. Just as you have to carefully sear the steak and whip the potatoes, here at Geisel we had the rather involved process of a clerkship lottery. Every day for a week and a half this April, second year students ranked their preferred locations for each rotation block (surgery, pediatrics, OB/GYN, etc.). For some, this process generated a bit of anxiety due to the lack of control—we are Type-A med students after all. However, it is completely worth it in the end because the luxury of learning clinical medicine at sites all over the country is unique to Geisel and one that prepares us well for residency and our careers beyond that.
Fourth year: Chocolate cake and a glass of wine
As far as I’ve heard from upperclassmen, the fourth year of medical school is pretty wonderful. You’ve figured out which specialty you enjoy most, you do advanced sub-internships in that field, and you see all corners of the country during residency interviews. The residency match happens in March and then you start the next chapter of your life! It’s the perfect ending to this whirlwind of education and digestion.
NOTE: I just realized that I failed to mention the very important USMLE Step I, also known as boards, which we take at the end of the second year. I suppose the boards are the irritating bout of indigestion that interrupts your feeding frenzy just before the main course. All you can do is chew some Tums and wait for the misery to pass.
Rachel Brickman is a second-year student at Geisel and a member of the Admissions Committee. She is originally from Atlanta, Georgia, and graduated from Amherst College in 2012, where she majored in Classics.
It’s 5:00 a.m. My favorite time of the day. The calmness of the early morning is quite unlike any other time of day. There is something about the tranquility at 5:00 a.m. that distills my deepest thoughts.
Today is a special kind of 5:00 a.m. Today I am taking a reflective journey the likes of which are far and few between. Today my 86 classmates and I get to choose the order in which we will be rotating through the various third-year clerkships.
At this point I can’t help but submit to the journey my mind takes me on, so many flashbacks almost all at once: the first time I donned a white medical coat, my first time at the hospital, the last day of the first year of school, the first time in the anatomy lab. I am also afforded a brief reminder of the feeling of taking my first medical school exam, surely not the fondest memory of them all.
These first two years have been an unbelievable experience. There is something truly unique about this training—its pace, its insistence, its unique ability to request and elicit your very best. We are two months away from being fully submerged in the clinical world and I can only imagine that true to the past two years, it’s going to get tougher, faster, and more exciting.
I’ve come to realize a truth about my classmates and myself. A truth our mentor at Geisel, Dr. Joe O’ Donnell has repeated from day one: We are enough. As we approach the next phase of our medical education I can’t help but smile to myself knowing that we are enough.
Inyang Udo-Inyang is a second-year student at Geisel and a member of the Urban Health Scholars. He is originally from Lagos, Nigeria, and graduated from Oberlin College in 2012, where he majored in biochemistry.