Transition to Year III-Clerkships

For 19 years straight I've sat quietly at a desk, taking notes, handing in homework and filling in countless ovals on Scantron™ test forms. In a couple of weeks, I'll set foot in a local hospital, stethoscope and reflex hammer packed tightly into the overstuffed pockets of my short white coat, full of energy and eager to do what it is that I came to medical school for-taking care of patients, real people who are really sick.

I'd be underestimating if I didn't say that I'm more than a little nervous. In fact I'm often terrified. Soon enough real doctors will expect ME to tell THEM what's wrong with their patients and be RIGHT! It's easy to study and eventually understand how asbestos damages some imaginary person's lungs. It's another thing completely to deduce a patient has been exposed to asbestos and that is what is now causing their breathing difficulty.

Not to say my first two years were easy, but now "we're playing for keeps." Patients will expect me to care for them. Sure I can smile and ask questions to review a complete history and physical. (It may take me 45 minutes, but I can do it.) But I will have to produce a list of possible problems and fix them. There's no more bluffing my way through with charm and boyish good looks. This seems to me to be a proverbial whole new enchilada.

I'm not always completely frozen with fear. In fact a whole bunch of me can't wait for July 28th. I actually get to take care of people! Sick people will get better because I helped our treatment team. I know not everybody gets better, but I get to at least get to help patients feel better, if not cure them. I've dreamed about this since I was seventeen, wearing a white coat, walking into the hospital my first day… instead of sitting in the library, peering in-between open books to catch glimpses of classmates frantically studying human anatomy atlases and taking pathophysiology review exams. I certainly didn't dream of studying 13 hours a day and feeling guilty for taking more than 20 minutes for lunch. I'm glad to be able to laugh knowingly and smile about anatomy class and USMLE I. Maybe I'm a bit bright-eyed and bushy-tailed about the first day, but I'm not going to apologize because I'm supposed to be excited. That's why I'm here.

For now, Wright State gives us some time in July to get used to the transition from academic study to learning directly from our patients. We have what I fondly call "make-sure-you-don't-make-a-complete-fool-of-yourself-in-the-hospital" class. We learn how to write legible admission orders and prescriptions, how to scrub-in and keep sterile during surgery without being forced to leave the room because I touched "bad," unsterile parts of my surgical gown, and how to listen to subtle heart murmurs and asthmatic lungs. I'm not complaining. Most of my friends at other medical schools across the country learn how to survive in the hospital wards on the fly. They tell me that it makes the first couple of weeks of 3rd year REALLY stressful. I'm glad I get to make mistakes for a couple more weeks without the fear of harming anyone. Come the end of July I'll be glad to have the safety net of nurses, residents, and attending physicians to check on me, but I can't wait to go to work and actually see and do all the procedures, medications, diseases, and treatments I've spent 2 years memorizing.

Andrew Jacques ('05)