My Learning Curve

Ryan, Third Year Medical Student

“Out of the frying pan, into the fire.” That’s exactly what it feels like to start 3rd year clinical rotations. One minute I’m exposed to a constant deluge of facts and information, expected to retain it all and regurgitate it on any number of exams. I blinked once or twice and now I’m in the hospital, playing the part of doctor. What a transition that has been! It’s one thing to identify a disease and recommend a treatment when you are taking an exam or reading a paper; it is completely different when you are faced with the same situation in real life.  The learning curve has been a steep one as over the first few weeks I’ve learned how to function in a practical sense rather than a hypothetical one.

So much has happened in these last few weeks that I could spend hours writing about it. Instead of talking your ear off, this is just one of the many experiences that stuck out.

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Welcome to KMC!

There I was, Day 1 at Kettering Medical Center in Kettering, Ohio. Step 1 (first step of medical boards) was finished only 2 ½ weeks ago, and I was as fresh and excited as a complete newbie could be.  After a quick orientation to the hospital, I found out I was to be working with Team Blue, a group of doctors that consisted of two interns (1st year residents), a senior resident, and an attending.  As luck would have it, that very first day our team was “on call,” which meant that our team had the added responsibility of staying late to admit new patients from the Emergency Department to the hospital.  There was no time to ease into the idea of being on the wards; this was the beginning!

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Orientation Tour – My Fellow LLU Classmates, Displaced to Ohio (minus Jehanna, who was just out of the shot!)

Now, have you ever heard of a “coding” patient? More formally known in hospitals as a “code blue,” this basically means a patient’s heart has either stopped beating well enough to move blood throughout the body, or it has stopped beating all together.  Needless to say, this is a medical emergency and direct intervention is required.  Because this can potentially happen at any time, different teams of doctors take turns holding responsibility for taking care of a patient that codes.

On the second call day of my time at Kettering, my team was sitting in the Emergency Department working on admitting patients.  All of sudden, all the teams’ pagers went off in perfect unison.  One of the interns looked up at the senior resident, his eyes popping wide enough to make me think he might have some underlying hyperthyroidism. Before I could ask what was going on, all three of them jumped out of their seats, sprinting away faster than I could comprehend, leaving their suddenly vacant chairs spinning. I looked over to an older doctor who was still sitting, holding the workroom door open.  “You going?” he asked without looking up from his work.  So I grabbed my stethoscope and ran!

You may have seen this happening on any number of completely unrealistic medical dramas on TV, but let me tell you, even in real life, when a patient is coding, you RUN!  Turning the corner, I managed to catch a glimpse of one of my intern’s coat tails flailing behind him, so I mustered the strength in my long and lanky limbs to go faster for fear that I might lose my team. As I ran, the intercom above spoke up, “Code Blue, Floor 3, Room XXX.” Kettering is a fairly busy hospital, so the hallways were pretty crowded, but I guess the sight of someone in a white coat running at top speed has the same effect as an ambulance bearing down the streets, lights blazing: everyone backed away and let us pass.  You may think I am describing this as an exciting event, but realizing this was no joking matter, what I felt was more of a panic, not knowing what to expect or what was wrong with the patient.

Several hallways, the main lobby, up three flights of stairs, and a couple sets of doors later, we were greeted by a line of nurses, directing us to the coding patient’s room.  Inside the room, there were about 15 people frantically calling out the patient’s vitals, handing each other tools, and questioning when the doctors would get here. Not even taking a moment to catch their breath, I watched as my team jumped into action, taking control of the chaos. Since I was only a student barely into my 3rd year, there was not much I could do to help at that point, but seeing the now organized chaos work to control the situation was astounding. Each member became part of a fluid machine, delivering life-saving care to someone who otherwise would not have had a chance.

This went on for a little while before the patient was deemed stable and her primary cardiologist arrived to assume care. Just like flipping a switch, everyone disbanded, and our team headed back downstairs to resume admitting patients. I looked up at one of the interns, “What just happened?!” His response was a simple, “How was your first code?” I was without an answer, and I don’t think I could have come up with a good one anyways! I wonder how long it will take me operate efficiently in a situation such as this.

So many things have happened, and I’m only four weeks in.  I’ve been cursed at, puked on, and smelled things I can’t describe. I’ve seen a heart stopped, repaired, and started back up again. I’ve felt foolish, brilliant, frustrated, and hopeful. I’ve been genuinely thanked one minute, and then questioned if I was even old enough to wear a white coat the next. And it’s only been four weeks! The learning curve has indeed been steep, but the bottom line is I absolutely love what I am doing, and I can’t picture myself anywhere else. More stories to come!

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Taking an Evening Off to Celebrate Ellen’s Birthday. From left –> right: Danielle, Jehanna, Ellen, David, Me

7 thoughts on “My Learning Curve

  1. I so wish my daughter would have made it past orientation of her 3rd year of med school to experience what you have. She took her own life then.

  2. Please accept my deepest condolences as well. I saw your thread on studentdoctor.net, and my heart sincerely aches for your loss. I will keep you and yours in my prayers!

  3. Ryan, I really enjoyed your story! I think of my dilute experiences and can’t wait get to where you are now. I’m applying to LLUSM this year and was hoping you would shed some light on the things in your first two years that helped to prepare you the most? Thanks so much for the blog posts!

  4. Hey Kevin, thanks for the comment and for reading! I could probably write several blog posts about your question as it’s a loaded topic (maybe I will soon!), but I’ll do my best to answer in a brief comment. The first two years of med school live up to the expectations you’ve probably already heard about: study study study, take a test, rinse, and repeat. If you aren’t careful, this can turn even the most enthusiastic new med students into mindless drones, constantly stressed out by the massive work load. It took me awhile, and I wrote about this in one of my other posts, but the way I started to avoid this trap is also what I feel helped prepare me as best as I could be for the wards. When you are studying in the pre-clinical years, you can’t look at it as a worthless exercise of read and regurgitate; if you focus your energy on learning how to become a better doctor rather than simply studying to get good grades, you’ll find yourself a lot less stressed and a lot more motivated. And guess what? That learning how to become a better doctor will translate into the good grades you need to advance anyways! That’s something I struggled with and working to overcome it has helped me immensely, both academically and mentally. I still have a lot to learn, and having patience with the process is hard sometimes, but I feel like I am on my way. Other than that, it’s study hard, take care of yourself, practice practice practice your history and physical taking skills, and always keep a positive attitude. Anyways, I hope that made sense and answered your question!

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