Letter 610: Musings of an "Advanced" Trainee

It is not very often that I get tiny pockets of quiet like now. It's 2 in the morning and my body's flooded with cortisol after the mad rush of the day that is just one of those days in the lives of a medical practitioner. But I'm deliriously awake-- and satisfied-- after being on my feet for 17 hours (that's why I don't have time for the gym anymore because I exercise in the wards). I had to retrieve 2 very sick patients, and it was just that feeling of finally getting it. Knowing what to do, what to pre-empt, and when to interfere. I get it. I finally get it now, after trying to perfect the craft and instinct over the last 12 months. There is no better feeling in the world than having your patient come up to you-- a good month or two after you had assisted in intubating her and retrieving her out for a massive coronary-- clutch your hands tightly, and say, with all sincerity and grace, "Thank you for saving my life." I couldn't take all credit, but I was extremely humbled by the whole sequence of events, and the fact that if we hadn't acted on early enough as we did on that fateful day, we would've lost a life. 

Often, medicine is not about saving lives. There's not a hell lot of drama involved, unless you include family meetings with weird and wonderful family members. But that's Psychiatry an entirely different story altogether. I dislike getting involved in family drama, but hey, that's part and parcel of what we do. Kind of like fecal dis-impaction. We took an oath, and although generally no one remembers the entire Hippocratic Oath by heart, we all abide by its first rule of thumb: Primum non nocere. First do no harm. The rest of it? One learns through experience. 

Now into my 4th year post-graduation, I look back and realise how little I'd learnt from med school despite the heavy duty lectures and coursework. Medical school gives you facts. Medicine gives you real life. And what I like about real life is the learning through human connection. No, it's not very scientific, but it is the artful side of medicine that seldom gets discussed among the medical profession (except perhaps Psychiatry). But I'll tell you why I like the art of medicine: I have this 2 year old boy with the curliest mop of blonde hair ever known to mankind. Every time his mom brings him in to see me, he'd waddle straight towards me and lifts up his arms, indicating that he wants to sit on my lap. So each consult would see him sitting on my lap, me taking a history from his amused mom, and him fiddling with my computer and other gadgets on my desk. At the end of the consult, he'd cry if I handed him back to his mom, and would only be placated with a little lolly. One time I had to carry all 15kg of him (see, I train my biceps in the clinic) to Accounts and sit him over the ledge of the counter, making sure me and his mom swapped positions so subtly that he'd end up back in mom's care while I surreptitiously tiptoed away to see my next patient. 

Then there was another blonde 2 year old boy who would be in the running for the title of "Handsomest Kid Under 5" if there was such a contest. Whenever I called his name in the waiting area, he'd scamper up to me and give me a high-five. So high-fives have sort of become our routine greeting. Sometimes I wondered if he'd grow out of it by the age of 3, but we shall see. 

I like old people too. Most of the time they're adorable. Like little kids. One slightly demented LOL keeps asking me if I've "got a man", and keeps reminding me that I "need to get a man" every time she sees me for her prescriptions. Some regulars know me well and can figuratively poke me in the ribs and say, "Don't think so hard, Junnie, or you might get a brain haemorrhage" when I'm confronted with a diagnostic conundrum they'd present with. And yes, my 88 year olds call me "Junnie". Like I'm their kid like that. Whatever. They're almost 90. 90 year olds can do whatever the bloody hell they want. Like pointing out to their friends and exclaiming, "There's my little doctor!" in glee when they happen to see me on the streets while strolling down the shops with their 4-wheel walkers, and still managing to tower over my short petite frame despite their osteoporotic hunches.

So you see, medicine isn't as dramatic as Hollywood has made it out to be. There is drama, there is comedy, there is soap, and there is hysterical mix of everything together at once. I came across an article titled "Top Ten Reasons Why You Should Not Go To Medical School... And The Single Reason You Should", written by a Dr Ali Binazir from Harvard. It has since been deleted on its original page, and while I found myself empathising with his reasons, I found the comments more enlightening. I am glad they have decided to leave the comments in because collectively, they reflect the realities of medicine. I cannot think of the number of times I almost wanted to give up med school and do something else with my life, but I'm not a quitter, and I persevered. I got through by some miraculous intervention of the divine, and realised that although there were times when I was suffering from bilateral hypersecretion of the lacrimal glands during the earlier years fresh out of med school, there were also joyful times. I wouldn't trade it in the world for anything now, because, as I've come to realise, sometimes it's not up to you to find your specialty. You specialty will find you in its own way. It may take a few years, or it may not, but you'll know once you've made the right decision. You will, as it's happened to me, get it.