2406; day eight i | jasper → vancouver
Oh man, where do I start on this?
It was fairly well into the night - 1am, if I recall correctly? My iPhone was somewhere in the pile of strewn papers, books, and technology. It was buzzing incessantly. Group chats are surely from the devil.
I think it was metabolism; oh but that is immaterial. There were many things to memorise - pathways, they call them. In a pathway, one thing leads to another, and actually in the end, it is quite fabulous, because something wonderful emerges. Take something simple like respiration, for instance. All your body needs are some raw materials, since all the enzymes are in place, and out the other end (of the mitochondria - well not really the other end) comes molecular energy.
'I speak the language', I was muttering in my head. I refer to the language of chemical reactions and catabolic pathways.
Something was not right. Here I was, copying out gibberish - not exactly gibberish, just molecular names, some of which might have come from Mars - and feeding them through my mind like a non-stop conveyor belt. Yet there was this apparent lack of cognition; I sensed that I was not making full use of my brain, and that I should probably multi-task - just because I could. I sensed that there were people who were doing just that - while they were making my phone buzz.
Sometimes we are able to put mind over matter and finish the 10 laps around the running track, or complete the chapter before dinnertime, but that is not always the case. It is especially not the case when we are hungry and tired both at once (the only worse thing being the terrible trio of hungry, tired, and the feeling you get after being in humid heat for many hours). There was no food near me, so all I could do was set my alarm for 7 in the morning and fall into much needed sleep. I now understand why they use the word ‘fall’ together with ‘sleep’. It can feel that way.
I find myself in the midst of a little university competition. It’s not for grades (nobody here really cares about an MBBS (Hons.)) or ‘who can be the best doctor’ (residency is still 4¾ years away). It’s instead about who can be the busiest - and I find myself flailing away somewhere at the back of the pack. It’s amazing how much some of these crazy people dump on their plates.
Right on top are the ‘beasts’. Some of them have scholarships, but that is by now, immaterial. It is life that we are fighting for, after all. Firstly, one has to continue playing the sport they’ve enjoyed since young, and competitively, I must add - if not, what’s the point? Next, to ‘keep an open mind’, it is important to partake in new activities, like 2 or 3 other sports, playing for the faculty, for the house, for the hall. Besides sport, being open minded also includes cultural activities and playing an instrument. Of course, one must also show concern for the community, so a couple of CIPs are thrown into the mix. Leadership is again something that employers want in their aspiring management trainees - so that necessitates committees and such.
Sometimes I find myself forgetting why I’m in university in the first place (besides all the philosophical reasons). Emails and Whatsapps fly in from all over the place, every single day, reminding me of things to do, and places to be. I had to write a bit ‘MBBS’ at the top of my commitment board as a reminder. I’m really supposed to be doing all this to get my degree.
We need to take a second look at this poisonous culture. What is the point of it all, really? Do these things matter in 10 years? Are they really enjoyable in the moment? Like any other addiction, maybe a little therapy ought to be on the way to elucidate things.
I love how she almost drops it until she smells it and that flashbulb memory hits.
“Real isn’t how you are made,” said the Skin Horse. “It’s a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY loves you, then you become Real … Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don’t matter at all, because once you are Real you can’t be ugly, except to people who don’t understand.”
Notice she says “who” it was and not “what” it was.
Oh I just gotta snuggle my baby bear!
Even as I write this, there is pride in being here - in this very room, this faculty, and doing these things. Truly sometimes you can hold your head high for there are people envious of the privilege that has been accorded to you. At other times, there is in some measure humility, and a distancing from the pride that comes from acknowledging that instead of ‘earning’ a place in medical school, you have simply been ‘placed’ here - by God, by your parents (and teachers or mentors in their efforts in educating you), by the admissions tutors.
It is also entirely possible that the reality of the profession hits you in the face, turns your world upside down, spins you 360 and wrecks all your premonitions about this respected, glamorous profession that promises guilt-free status and generous remuneration.
From the word go, it is evident that society demands hard work of their doctors - that the wise advice from the doctor you shadowed was actually utterly truthful. As successful applicants to such a competitive course, we often trust too much in our invincibilities, falsely believing that they will carry us through the tough times. This is where many realise their invincibilities were false titles conferred upon them by white lie-telling people who may likely have been well-meaning.
Within my first month of school, I learnt to take blood pressure. Most of us know this today as the cuff you wrap around your arm and the button on the little electronic monitor you press. Yet most clinics do it the old-fashioned way, with a sphygmomanometer. Because the mercury falls so quickly, and the patient’s unattenuated pulse is only heard by the person taking the BP, you could technically smile and lie about the reading through your teeth. Say for instance you miss the first reading (as I did, the first time I tried), and can’t quite figure out what it was - do you tell the patient you’re sorry and will take his BP again, revealing your incompetence, or simply lie about the reading? It is so easy to do the second, but that is not what the trust in our doctors has been built upon. A reading as simple as that can have serious bearing on the patient’s life.
Many will make it past this first stage - the admissions process has selected only the brightest, after all. But between then and now, which is a highly variable period of time, it may have blossomed in many of these young minds that they should very much enjoy being like Dr. House, who is merely concerned about the mind-stretching clinical problem solving and the spewing of jargon no layman can decipher. Perhaps others still desire the opposite.
The second hurdle really comes when one realises that medicine is not for pride or knowledge, but all and only for the patient. It can be very disconcerting to realise who the patient is. While prestigious careers like law or finance can be entirely undertaken in an environment where there only exist plush carpets, walnut desks and champagne, medicine is inevitably dirty. One does not have to go very far to realise that the bulk of today’s patients are elderly, with half a dozen conditions and a dozen medications to cope with those conditions. Many of them live where we privileged few consider unliveable, and carry to the clinic signs that they do.
It is thus an undertaking for the brave. It is saddening to think how many begin their pursuit without true knowledge - almost as if going shopping on a whim, after that pompous ad. Yet it is comforting, to see that out of these will emerge many who have come up from their falls, to decide that medicine is after all for them, and that they will be brave.
I am yet unsure of where I can allow myself to stand. One part of almost everyone wants to place themselves above the rest, even if only a little bit higher. We want to see the world from an elevated perspective, and convince ourselves that we are not fallible to the downfalls ‘the rest’ are at risk of. The other bit screams that nothing in this profession allows pride, that complacency only smarts the dynamics of healthcare.
At the end of the day, we all want to make some sort of difference. Some differences are more mainstream, like the conventional policy, research, or ‘difference to someone’s life’ kind of difference; it doesn’t really matter, honestly. What matters most is that there is a way to achieve it.
It is indeed a decent number of long years before there is some settling. I think it starts now by saying that I’m doing this because there are people who can be comforted, and this is my way of making a difference.