July 23, 2012

Helpless

I cannot do this

From her mouth
come relentless screams--
treble octaves of agony
wound through with fear and hunger

The sound pierces
my gut, my head, my heart,
a voice of pure anguish
that precedes language

I am not prepared to feel this way--
lost, at a loss, losing my mind

I cannot do this

Even a mother's touch cannot soothe
the brain waves that are "grossly abnormal."

We take the history,
the dates and battlefields,
temper tantrums and staring fits,
and map her decline.

We shout over the artillery shrieks
as the three year old patient
hurls her tiny body from side to side,
head ricocheting violently close to bed rails.

The silent hallway and the emptiness
of the stairwell define shell-shock:
phantom echoes from her room.
I hear only fury and terror,
the pitched clamor of torment.

I am outside myself
In my head run the words:
I cannot do this

July 12, 2012

Newly-minted

Professionalism, like our white coats, is something you can slip into. It is smooth and unruffled; it is the calm in the midst of a storm; it is the decisive general in the heat of battle; it is doing what is expected of you to the utmost of your ability; it is striving to increase your knowledge so that you are always ready to make decisions.

Knowledge and capability are the perfume of professionals. They surround them in a cloud, hints of expertise and lingering high notes of compassion floating over heavy notes of reasoning and responsibility. You can almost see the haze of competence trailing behind the attendings and residents on rounds.

To step onto the wards of the hospital as a newly-minted junior medical student is to enter the unknown. It is to face yourself in the mirror every evening and ask, "Did I do everything I possibly could for my patients?" Third year is about learning to listen to your own voice, the one that whispers the answers during rounds but dies without crossing your lips. This is also a time to speak up and be corrected for your erroneous ways, because as junior medical students we know enough to be dangerous or foolish and not enough to be entirely useful all the time.

We have been in the hospital for two weeks now, and already I can feel the strands of professionalism weaving themselves into a coat around my shoulders. The responsibility I feel for my patients weighs on me, lends my enthusiasm a measure of gravitas. I leave for home wondering what else I should read to better understand their disease, asking myself what I will need to know to help them tomorrow.

I feel like a professional--some of the time. Who knows, though? I'm still only a (brand-new) junior medical student. I can barely find the patient's elbow.