The day we finished our last final exam, my Facebook newsfeed was paved with my classmates' excited declarations that we were a quarter of the way through med school, that we were 25% doctors. They weren't quite correct, though, since we still had the Y1 elective left to get through.
That was five weeks ago, and I am now on the last week of my six-week elective rotation in the Plastic and Reconstructive Surgery department of the Princess Alexandra Hospital. My first year of medical school is really finally drawing to a close, and... well, I hardly feel like I'm 25% doctor.
Good grief. Make that 0.00001% and I might consider it.
I don't mean that I haven't learned anything this year, because oh, I have. I have learned so much, not just from the endless lectures and PBLs and piles of textbooks, but also from my friends and classmates and clinical coaches, and the doctors and nurses and fourth-years who taught me so willingly during my elective. And most of all from the patients who greeted a mere first-year student with an encouraging smile, patiently answered my incoherent questions, and unhesitatingly shared their stories with me.
A lot of the stories were sad, made particularly so by the fact that these are real things happening to real people. I met a 44-year-old gentleman who had previously had several big operations to remove cancers, and then had to have half his jaw removed in another operation because of yet more cancer. He had chosen to have this done instead of going on his honeymoon, and we found yet more tumors on the other side of his face that the scans hadn't picked up... How do you tell a young man -- and he is young, compared to the majority of the patient population -- that even after all that, he doesn't have long to live? That his cancer is spreading quickly despite our best efforts, and maybe he should have gone on that honeymoon instead of getting the surgery?
There was also that 25-year-old gentleman whose hand got caught in heavy machinery at work. After five hours of painstakingly piecing together the fragments of bone and grafting blood vessels together, the doctors managed to save one of the three crushed fingers. He'll have to live the rest of his life with just the thumb, index finger, and little finger on his left hand, and the index finger probably won't even work as well as it did.
And that 67-year-old lady who came to get a mole examined, only to learn that it was actually a massive tumor growing into her head. The excision and reconstruction involved three surgical departments, as well as two medical departments to stabilize her after each operation. I see her on the ward every day, and she seems so tired and unwell, it makes me wonder if she ever regrets getting the checkup that led to all this.
And what about that 33-year-old lady who lost both legs just a month ago due to necrotizing fasciitis arising from enteric sepsis? And then just last week she lost her right forearm and left fingers, including the thumb. How do you even begin that conversation about what needs to be done?
But shockingly, it's not all bad. If it were, I honestly don't think anyone would, or even could, stay in the profession. You meet people from all walks of life, who face these hardships bravely and cheerfully, and it's frankly amazing. There was that 83-year-old gentleman whose toe was amputated on my very first day at the hospital. He also had multiple skin cancers removed in the same operation, as well as his inguinal lymph nodes from one leg. He must have been in so much pain once the analgesia wore off, but he greeted us cheerily every morning, often with a cheeky smile and a joke for the female doctors and nurses.
And that 64-year-old gentleman who had a cancerous lump the size of a cue ball removed from the back of his head just last Friday, who greeted us on Monday morning with a big smile. He thanked everyone for a job well done, never letting on how uncomfortable it was to have to keep his neck extended all the time.
My personal favorite was the 92-year-old lady with a skin cancer near her left lower eyelid. She told me she was worried that the operation to remove the cancer would affect her eyesight, because then she wouldn't be able to "help the old people read the bingo numbers" at the local nursing home where she volunteers three days a week.
It has been a fantastic six weeks, easily one of the best experiences from my first year of medical school. On the one hand I am completely overwhelmed to realize just how little I actually know and what a long, long way there is still to go. When, if ever, will I reach that level where I feel it is safe for people to put their lives into my hands? But on the other hand, I think this experience has rekindled my motivation after an exhausting year. I only have three more years to learn as much as I can, before I become a doctor and take on the enormous responsibility that comes with the title.
I only hope I'll be ready for it.
