Reflection.

It's approximately the halfway point of the semester, so I thought I'd write something a bit different and perhaps more reflective than the usual "This is what I saw" entry.

Even though I've only been in the hospital for two months, I definitely feel that my perspective has changed about a lot of things related to medicine and medical education. I realize I am incredibly lucky to be able to see the inner workings of medicine this early in my career, but at the same time I'm realizing that I'm also being soured in some ways by what I have seen.

Take, for example, the barbaric ritual known as "night float," in which a SINGLE intern is responsible for keeping 50+ patients alive through the night. It is always easy to spot the unlucky individual the next morning, because he or she looks absolutely dead from running all around the hospital all night long. I haven't yet entered med school and already I am dreading night float.

The crappy treatment med students and residents must endure is probably the biggest turn-off for me. There is a huge discontinuity between what is taught during the first two years of med school and the scut work the 3rd- and 4th-year students and residents must perform as part of their training. You don't need a medical degree to wipe up vomit or run to get your attending a cup of coffee. It's discouraging to know that even after putting in this much time and energy into my education, it will still be many, many years before I'm no longer at the bottom of the totem pole.

Though the vast majority of the doctors and nurses have been friendly and encouraging, I've encountered enough big egos and less-than-sensitive types to have lost some of my initial naivete. After mentioning that I liked being in the OR, I've been told that women should not become surgeons. I've been warned not to form any long-term relationships because I will not be able to maintain them through the clinical years. I've been told once or twice to reconsider the entire field and get out before I'm too deeply immersed in student loans to turn back. None of these remarks have had their desired effect; I still think I can be happy and successful in medicine, but they certainly put a bit of a damper on my enthusiasm.

As I said, it's a mixed blessing to be in the hospital before starting med school. Yes, I have a much clearer picture of what I will be facing in a few years and yes, I am comfortable with moving around the hospital and walking into patients' rooms and all of that, but the enormity of my decision to become a physician is brought to the forefront of my mind every time I watch a procedure or hear a code announced on the loudspeaker. The pressure to perform well has already begun, and it will only get much, much worse come August. I'm trying not to psych myself out and for the most part I think I'm doing okay, but my few moments of self-doubt have been paralyzing in a way I've never experienced before.

I could go on, but I'll save the rest for future posts. Homework calls.