the 3rd Degree

Every culture has its rites of passage, its traditions. Moments shared by all members even if they are separated by the span of time. These rituals provide a point reflection, a sense of belonging. Some of these rites are light and easy others are a bit harsher. In these later cases the community is united not simply by unity of purpose but also by shared trenches of life in their culture.

Let me be plain beyond all the religion academia flowerily language. Hazing is alive and well in the medical profession. I am sure I will become more acquainted to its many forms. Yesterday I had my first initiation rite. On the schedule it said Wed was devoted to INFECTION CONTROL which apparently is a cover for to learning how to do five basic procedures: lumbar puncture, IV insertion, central lines and port cath care, Arterial Blood Gases and Foley catheter insertion which is a further cover for medical student HAZING.

My group’s afternoon started out fairly mild. We all managed to obtain a syringe of pink Kool Aid from a mannequin’s radial artery. Feeling pleased with ourselves we marched on to central lines and port cath care and flushed with the best of them. With our confidence we walked into the Foley catheter insertion.

We knew of course what a Foley catheter was (bladder catheter used to help very sick folks pee) but I don’t think we had fully taken in account the fact that we would be clumsily manipulating various, life like model organs of the pelvic region in a large group setting. While we tried desperately to be mature and professional, it was hard not to at least step back and think of the sheer absurdity of the moment. Particularly when we were told to grasp and don’t let go. COMMIT, COMMIT, they cried. What a strange way to make a living.

Next was IV insertion, we were expecting mannequins and Kool AID but rumors from previous groups has spread that we were sticking each other. As we walked into the room and found no mannequins, we knew the rumors were true. Anxiety spread through the crowd like wildfire. It should be noted at this point that my closest friend in medical school nearly passed out the previous day during our routine communal PPD (TB) testing. I told K and J we could be a group of three and they could each stick me because I’ve been stuck a million times. That way K didn’t have to pass out in front of everyone (and I didn’t have to be the cause of it). This seemed like a good plan as we settled into our sits. Our group of three was spotted by one of the nurses and we explained K’s situation and she said it was fine.

She then went to covey this news to the nurse in charge. The nurse in charge came over and knelt down next to us in that somewhat patronizing way people do when they are talking to little kids and explained that EVERYONE STICKS and EVERYONE GET STUCK. She explained that several of our classmates had cried already that day but ALL of them had been stuck and had stuck. We do this, she says, so you can relate to your patients. She pats K’s arm and tells her if necessary they could lay her on the floor and stick her from that position so she didn’t injure herself if she really did pass out.

K is of course somewhat shocked, embarrassed and terrified, two other classmates already look near tears after this speech. The charge nurse got up and described the details of the procedure and as she did I couldn’t help but wonder how many other professional schools require communal blood letting? I mean its one thing to take blood for the purpose of making someone better in the long run its another to force healthy people to undergo it at the hands of extremely inexperienced students somewhat against their will ….number 478 why Divinity school probably would have been less painful.

The patient part of me for a split second pondered the irony of the a bunch med students terrified of IVs but over eager to stick others. But I suppressed these thoughts because it would reinforce the us vs. them mentality which I despise. And frankly the point of the exercise was to show how similar we really were to our patients.

I got stuck and my partner J managed to find my vein after 60 seconds or so of moderately, uncomfortable digging. Then it was my turn, I looked around the room and many of my classmates were struggling to get a vein. They all had average hands with normal biomechanics, the odds were against me. I apologized to J in advance as I tied the tourniquet. I COMMITED and stuck praying that the blue line would stay taunt nd still, I went too deep, then nearly came out (would had to start all over again), then all of the sudden dark blood spilled into the catheter I looked around wildly, what, what do I do now I asked? I managed to slightly screw up the needle retraction because I was so darn shocked I got it.

K managed to avoid the sticking by sheer luck, we had an odd number of people, so she managed to sort hide in the corner for the duration of the class. We were preparing to leave when all of the sudden someone asks if K has stuck anyone. We answer honestly and I offer up my arm praying that we will run out of time before I have to return the favor. At the other end of the room, the charge nurse is comforting another classmate who is now crying softly as a panicked classmate tries to no avail to get a vein. I sincerely hoped that would not be me and K in five minutes. We were saved by the clock, the next group arrived after 20-40 seconds of K digging in my other wrist. We waited outside for the distressed classmate and her partner and practically ran to our last seminar.

Today the entire third year class have matching bruises on our arms….its like my naval officer father always says The Beatings will continue till Morale Improves. For better or for worse we have been initiated now into some strange fraternity.

…And no I can’t tell you the secret handshake

woot woot

I will write a real actual narrative about third year orientation tomorrow!!!

But a quick preview…. DRUMROLL!!!!!!!!!!!!!!!!!!!!

I started an IV on my first stick on my first try ever.

I don’t think you can fully understand how amazing that is inless you are a mutant med student.  I expected to fail miserably and while I wasn’t exactly graceful and made a rookie mistake or two I got it and many of my average non mutant classmates didn’t it was a nice gift form above.

more on the strange experience of forced blood draws on our entire class tomorrow…

Life as we know it

I kind of lost it last week. I somehow managed to keep the insanity at bay till after the boards but then Tuesday morning or really Monday night I just suddenly couldn’t hold on any more.  And I just cried and cried more than I ever remember crying.  It wasn’t really the boards if anything it was the fact they were over and I now had to face going back to medical school which apparently was a very negative idea.  Really since last Sept I have been chronically disillusioned with my decision to pursue medicine. I have blogged about it but I haven’t really talked about it to anyone beyond a few very close friends and family members.  No one from medical school and very few people from my life in Winston even know. I never really decided it was a big secret but apparently it was.

So there I am sobbing on the porch swing on a gorgeous Spring Day with my Dad trying to figure out what the heck has happened.  I am just a mess of exhaustion, frustration and hysterics. Then slowly it just all spills out all my doubts, all my loathing for aspects of the medical profession and all my desires and fears of entrapment in a job I hate that consumes my life. I just laid it all out and I was shocked at how forthcoming I was. Once it was out there I was numb, spent.  I fled to an old haunt of mine high up away from civilization and just sat in silence for a while.

I woke up at dawn last Wed and packed my car, said good bye to my mom and drove south.  I was standing in the Dean’s Office by 9. I was composed and calm and I did exactly what I had done to my Dad (minus the hysterics, with considerably better diction and syntax) the day before.  I kept waiting to feel  foolish and melodramatic and vulernable but I didn’t. I felt incredibly relieved.  O (the Dean) didn’t shoot me down or tell me to suck it up.  He offered a single comment that wasn’t particularly profound or earth shattering. But it was something that strayed slightly from the party line of: life will get better third year, you will be a good doctor, look how well you are doing and we really need people like you in medicine.  He told me something to the effect: The problem with you and medicine is you already know exactly what you want in life and who you are. The average 23 yr old med student comes in looking for a system to fit into, you came in wanting the system to fit into your vision of what it should be.  Its not a problem necessarily he went on to say but its certainly makes life different. Think about your decision, he told me, but you will know what to do when its time to make it.

Somewhere over Mississippi I just came back together. It wasn’t the advice or the sobbing. It was the falling apart and admitting it.  I supposed somewhere in the mist of second year   I buried my theology for a time under a pile of endless notes, small disasters and an endless flood of personal perfectionism.  It is in our brokenness that we are whole.  It is admitting  our doubts we keep our faith in our God, in our visions and in ourselves.

the aftermath

The last 6 days have been down right glorious. There are few pleasures in life more sweet and more comforting than the affection and company of old friends and your family. The sort of people who you haven’t seen in a year or even two and despite the fact your life has changed and evolved, your relationship is the same.  Conversations, tea, gardens, long walks and quiet understanding of people who know you nearly as well you know yourself, in some ways better.

I spent a great deal of time outdoors in the Blue Ridge Mts with my Mom and sisters post-boards. I left my cell phone and computer and books in the corner and forgot that I have the cartilage of an 85 year old and wandered around my favorite mountain celebrating the tentative Virginia Spring with its red buds, Bradford Pear Trees, bulbs and shy buds. I had a long talk with my Dad about life then I moved my stuff back to Winston sans all my school stuff. I just left it in my basement. It was liberating.

I flew to Texas to see Karen and Jon. I soaked in the sunshine, the hippee-ness of Austin and the affection of dear friends. We cooked, talked, stayed up too late, wandered around San Antonio in the middle of the Final Four craziness, ate REAL Mexican food and Americanized Romanian food???, reconnected with a random kid I met in Romania and mostly just talked, solved the world’s problems, told stories and laughed. It was lovely.

On the school front, my life seems to be working out too well. I not only got the sced of my choice, I got the attendings I wanted for surgery which is completely a GOD thing because I never confided in anyone about such.

And now to bed since I have slept much in days…too much fun to be had.