September 11, 2007

Reflections After a Whole Year in Medical School

Posted in Iramville at 4:58 pm by Iram

I began to pave my path to medical school many years ago, at the young age of 4. I was in Pakistan, visiting my extended family, when the neighbor knocked on our door. She was in a desperate state, carrying her young son in her arms, and was begging for the help of my aunt who was the only physician at the time in our family. I don’t remember many of the details regarding the child’s illness or my aunt’s treatment, but I do remember announcing to everyone right then and there that one day I would be a doctor so that I could help the neighbors too. Since then, I have done quite a bit of growing and maturing, but even on entering medical school last year and donning the shortened version of the white coat my ultimate goal was the same: I was here to help people and make their lives, and even their deaths, better and more bearable.

The first year of school has changed my perspectives on a career in medicine quite profoundly. I have learned a lot about the complicated nature of my goal. I have seen patients deny our care, preferring a “dignified death” to pills and side-effects that promise to keep their brain functioning and their heart beating but cannot cure their ailing souls. I have witnessed physicians teetering across the gray line between minor manipulation and outright fraud in order to provide patients with the care that they need but cannot, by any means, afford. I have experienced the difficulty of juggling multiple responsibilities while constantly staring at the second hand that simply will not tick any slower. Overall, beyond the textbooks, studying and exams that define the first two years of medical school, I have learned a lot about what struggles physicians face on a day to day basis trying to ensure that every single individual under their care receives – and accepts – the appropriate treatment. Issues such as patient autonomy, Medicare, palliative care and noncompliance have moved from being in a mere shadow in some dark corner of my unconscious mind to the forefront of my conscious thought. Throughout all of this, though, my ultimate goal has not changed. I am still here to better the quality of life and death of those around me who honor me by putting their health into my hands. And although I can now recognize, and even lament at, the many roadblocks that make such a noble path so difficult, it has only furthered my appreciation for all of the health care providers that continue to put in their best effort at patient care.

Life as a physician will never be easy, certainly not in the field of Family Medicine that I currently plan to pursue. When you are delivering life into the world with one hand, you are covering a face with stark white sheets with the other. Time spent with family inevitably turns into time shared with a pager and a cell phone, giving instructions to strangers on the other end of the line. I still have several years before I hit this stage in my career, but when I do I hope to be able to incorporate some ideals into my lifestyle that will not only help me serve my patients better, but will also help me maintain my own health and family relationships. I want to be the doctor that is always available to help – whether my patients come in with an illogical concern to which I simply have to patiently listen, or they come to me injured and bleeding hoping for ointment for their wounds. At the same time, I also want to be the doctor that knows when to shut the phone off and pay attention to my own family members, who will someday contribute to the world’s future in a way that I myself will never be able. I also want to be the physician that realizes that my own health needs to be at the top of my priority list; I cannot help my patients if I myself am not in prime condition to think and act. I never want to give up on new ideas and treatments, or close my mind to innovative research projects, but at the same time I never want to recommend any of these to my patients without thoroughly doing my homework first. And perhaps most importantly, I would like to gain the respect and trust of my colleagues and friends and have them know that I will never do anything less than what is within my means to approach any situation that is brought to me. I think my ideals are best summed up by the poet Ralph Waldo Emerson:

“To laugh often and much; To win the respect of intelligent people and the affection of children; To earn the appreciation of honest critics and endure the betrayal of false friends; To appreciate beauty, to find the best in others; To leave the world a bit better, whether by a healthy child, a garden patch or a redeemed social condition; To know even one life has breathed easier because you have lived. This is the meaning of success.”

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