Today, in the midst of seeing office patients, I checked my cell phone and browsed the Internet and I noticed a picture of the 11th class at LECOM Bradenton – my medical school- appear on my phone. I smiled and memories came flooding back. After my long stretch seeing patients, I sat back at the end of my day at my desk. In my office. I am really a doctor? Wow. I remember how I felt 10 years ago before I began this whole process. I started to think to myself, “How did I get here?”. From lecture hall to exam room, I had to think back to the ten years that separate me from being a 23 year old medical student and a 33 year old board certified Internist.
I remember the move from my parents’ home in Aliquippa, PA, loading my tiny black ’97 Toyota Tercel with vacuum sealed storage bags full of clothes, books, photos, and other memorabilia. In August of 2004, when I left my parents house, I began my trek to Bradenton, Florida. Unbeknownst to me, I was actually embarking upon a new journey – one that would transform me completely.
Sure, becoming a physician is all that I had ever known. I worked diligently for 4 years of college, sacrificed a summer to prepare for the MCATs and tooka prep course. I remember being accepted to LECOM (Lake Erie of Osteopathic Medicine in Bradenton). I knew I was prepared – I spent time as a nurses aide/orderly, I had watched every episode of the most inspirational medical show of my day – ER. I had high hopes. I was dreaming big. I just wish that I could go back in time to talk to myself 10 years ago.
As I said, medical school transformed me into a different person. I am not the same young, impressionable 23 year old young man that I was back then. I have watched people being born, I have watched people die. I have sat with grieving families. In some ways I have become jaded. Not all patients have liked me and I found some that I didn’t like. There are days when I love what I do, there are days when I wish I were as innocent as I was before that first day of medical school. I figured I might as well take a break from the electronic medical records for the night (don’t worry, you will learn about them soon enough) and share my thoughts with those who are beginning medical school around the country.
So, here is my letter to the men and women, mostly in their 20s and 30s, but don’t forget the 40s, 50 year olds as well, beginning medical school this week or in the upcoming weeks:
Dear medical student,
Congratulations. The MCAT preparation worked. You can now forget the organic chemistry that you have learned. It will not really have any place where you are headed in the next few weeks, months or years.
Your hard work and determination got you here, now you have to keep your head above water.
I remember how I felt 10 years ago as I was about to embark upon a truly life altering adventure – learning the art of medicine. I am not the same person that I was before that first anatomy lecture. I have changed. I am more knowledgeable, but also wiser. I have at times lost some of my humanity – that same humanity that drove me towards the medical profession. It will happen but you can control the degree to which you experience it.
During the first year, you will face adversity. Medical knowledge will be hurled at you. No, actually, someone will turn on a fire hose and that pressurized water will knock you off your feet. Have you heard the saying that medical school is like trying to drink from a fire hose or fire hydrant? You will not remember every modicum of information from anatomy lectures or your time reading medical texts. Please do me one favor – take pause and enjoy the miracle of the human body – learning the anatomy and how we are built. Be grateful to those who donated their bodies to science, they have given you a precious gift.
You will soon come to realize that no one seems to quite understand the life of a medical student – a future physician. You are a driven person, who thirsts for knowledge. You live for learning and comprehending the ins and outs of the body. You are prepared to dive in, head first, but are you ready to tread? Keep treading water. And when you tire, continue to tread. Medical school does not have to be difficult, its just a different way of learning. Are you still treading water ? Good, don’t stop.
At times, you may wonder what has happened to you. You used to feel “normal”. You may start to second guess yourself. You may dream about cadavers and lectures. Don’t be bothered by it – it just means that you are starting to live and breathe medicine. It will be a sign that you are on the right track and cut out for this. Get ready, because you will breathe and live medicine for the rest of your life. You are never off duty. Be it a friend or a relative, someone will always have a medical question for you. If you don’t understand what I mean just yet, you will (maybe in about 4 or 5 years)
You don’t have to do this alone. Make friends with your classmates. The reason that I believe my class of 2008 from LECOM Bradenton has done so well in our training programs and careers is because not only were we academically astute, but also socially adept. We were an affable group. Take the time to talk to the person sitting to your left and your right in the lecture hall. (Ben Thompson sat to my right and Azeem Vasi sat to my left, I still remember this 10 years later).
Help one another. Don’t be a gunner. No one likes a gunner and everyone will be able to see right through you. Be diligent, strive to learn and develop a profound knowledge base, but do not do it at the expense of your classmates. Help one another so that you all succeed. You are studying to become a doctor, a physician, a healer. If you can’t get along with your classmates, what makes you think you will get along with patients?
When you decide to go out for a study session with classmates, with your new friends, make small talk with people at Starbucks or whatever coffee shop you choose to make your home when you don’t want to sit in the library. During my first two years of medical school, a group of us were friendly with the Starbucks staff. We learned who the regular customers were. If you are not good a making small talk, then you definitely need to go to a coffee shop. Open your Netters or Grants Anatomy Atlas and display them for all to see. You will surely attract attention from customers passing by your table. Instead of gloating to them about how you plan to specialize in this or that, learn how to engage other human beings.
In addition to learning how to talk, you must learn how to laugh. I remember a classmate of mine commenting early on in our first semester of medical school that she could pick my laugh out of a crowd. If I didn’t laugh, I would have done a lot of crying. Laughter is still the best medicine and since you want to practice medicine, this is one fact you should learn and know.
Aside from laughing and making small talk, learn how to listen. If you go into primary care, Internal Medicine, as I have chosen to do, you spend about 40+ hours a week just listening to people. Most of a patient’s office visit is letting the patient talk, with guided questions of course. Learn to listen to your classmates, to those people in the coffee shop (the one you will be visiting, because, you will need caffeine).
In medical school, a classmate Josh and I met a woman named Ruenel who had a dog named Aristotle. Of course we met her at Starbucks. She told us how she was diagnosed with a pheochromocytoma and how it took physicians 5 years to catch it. She told us how her doctors chalked it up to her just “being anxious”. Her doctors near 29 Palms California didn’t listen to her and she felt like they ignored her and were simply treating symptoms, not the person. She was happy to share her story with us, in a sense to remind us to listen to our patients. How do I remember this story? Well, because we talked to her several times per week when she came to Starbucks on University Boulevard. Did you realize that you will be graded on how you treat patients as health care now allows us to be evaluated based on our bedside manner? Learn it now and you will be ahead of the curve. Learn to treat the WHOLE person, not just a disease process.
(If you asking yourself what a pheochromocytoma is…get used to hearing these three words from now until the end of residency “look it up”).
You will have moments when you feel like you are being weighed down by the vast amount of knowledge you are expected to consume, process, regurgitate and then retain. No worries, it will all make sense some day. Trust me.
Picture this – you are building a mansion, maybe a beautiful hotel like the Bellagio in Vegas. Before the hotel is build, cement is poured, plans are drawn up, a foundation is laid. You must work diligently to lay a proper foundation now. Learning the anatomy, biochemistry, pharmacology, embryology will all help to build your knowledge base which. Your knowledge will accumulate and hopefully you will become wise. Continue to read and read. You need to practice. Practice doesn’t make perfect, it just makes you better.
There are things you will learn now in medical school that believe it or not, you will recall 10 years from now. I know that Ito cells in the liver store Vitamin A. It made me look like a rock star on rounds one day in residency, and I still remember the Winged Scapula is due to a damaged serratus anterior muscle – thanks to a great anatomist like Dr. Frank Liuzzi. LR6 SO4, all others 3 – the muscular innervation of the eye, courtesy of Dr. Jon Leo.
Come up with mnemonics, they will help. Make learning fun- if it isn’t fun, and you cannot enjoy it now, you won’t enjoy it in a few years when you are in practice. You are now a lifelong learner. Its just beginning and it never ends.
You will start to over think. You may already be an “over thinker”. If you aren’t, you then you are doomed to become one. That’s a good thing – you need to be particular and precise. One day lives will be in your hands. You will be giving the orders during a cardiac arrest, telling the code team what to do. You will save some lives, some you will lose. Nothing is perfect, no one is perfect. Learn from your mistakes or a bad situation.
You are making a great financial investment into your education. You are purchasing text books – which will cost thousands of dollars. You are investing your time in studying and learning. However, the best investment that you can make is in people. No matter what the outcome, you always win, you always gain some sort of return from that investment. The more you learn more about others, the more you will learn about yourself.
Remember to breathe during that first anatomy exam, point out the person in the anatomy lab that first day who looks faint and stand behind them – someone will pass out most likely. Be there to catch them (It happened to someone in my class).
Look around the lecture hall every day when you get to class. You never know – your classmates may be co-residents with you, one of them may become your spouse, or may become your colleagues one day. What i wouldn’t give to have a late night study session with my friends at Starbucks or Kelly, Andrew and Julie’s house. I got by with a little help from my friends, to quote Joe Cocker. I miss them dearly but we reached our destination together. I met some of my best friends in medical school.
Be grateful for the gifts and talents you have been given and prepare yourself to share them with the world.
Did I mention not to lose your humanity? I wanted to save the world when I was a pre-med. I think we all do – that’s why we went to medical school. There will be moments in the next few weeks or months that you think, “Why did I get myself into this?”. You will still do that as an attending. And then, you will have a day like I did today, and an 89 year old patient will come in for her appointment bearing a baked gift of home made pizzelles (one of my favorite cookies) and a card (pictured below), and you remember why you can’t picture yourself doing anything other than this. I’m sitting here enjoying those pizzelles right now as I write to you
So, Good luck, take a deep breath. Check your pulse and make sure you are calm. And most importantly, enjoy the ride. And when you receive the short white lab coat, be proud of what you are accomplishing. You will earn that long lab coat in time. Becoming a doctor is a journey, not a destination.
Sam Urick III, D.O.
LECOM Bradenton Class of 2008