July 3, 2011

wax on, wax off

the manfriend and I went on a run the other day and talked about the goals of third year

it's such a strange middle state between the past few years of everything being about how much we learned, and years before that (and years to come) of us being actual working people who are performing a job and a service that is important. I've been feeling really badly about performing exams on patients who have already had exams performed on them just so I can learn.
But I was recently reminded that except for the patients, the medical students are the only other people actually PAYING to be at the hospital.

which brings me back to my original question: what are we supposed to be doing right now?
and what we came up with is that this time period is sort of a mix between
(1) an apprenticeship,
(2) a consumer of an educational experience (sometimes to the annoyance of many other people) and (3) kinda, maybe, sorta in a very small way actually helping people

because of this, we have moments where we find ourselves assigned to do things that do not seem helpful to either our patients or to our learning, which I'm now calling the WAX ON/WAX OFF PART OF THIRD YEAR. This includes getting to the hospital to be on call at 7am on a Sunday even though we don't have any patients, standing by an inebriated patient as he recovers slowly to make sure he doesn't leave the hospital, holding a baby for 5 hours of overnight call because it just had surgery and screams every time it's put down in a crib.

I'm not saying these aren't also learning experiences, but it's more the way the karate kid had to learn the discipline of karate by washing Mr. Miyagi's car. We learn the discipline of medicine from these things - what you learn when you just listen, what a hospital is like at night, the frustration of not getting to do everything else you want to do in your life because you have responsibilities.

But there's also the consumer of education part where I have to remind myself that I need to examine this patient not because no one else is examining him (many people are), or because I'm likely to see something everyone else has missed (that seems unlikely) but because someday I'm going to have patients like him and I'm going to need to know how to do the exam and what to be looking for. And (and here's part of the maybe, sorta, just a little bit helping people piece) he's receiving better care because he's at a hospital where people are constantly thinking about how to do the exam correctly and what they should be looking for, and they are doing this a lot because they have people like me around asking them about it.


Daniel: Wouldn't a fly swatter be easier?
Miyagi: Man who catch fly with chopstick accomplish anything.
Daniel: Ever catch one?
Miyagi: Not yet.


Miyagi: First learn stand, then learn fly. Nature rule, Daniel-san, not mine.

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