Living up to the White Coat

Tiffany, First Year Medical Student

Note: This entry was originally written on August 1, 2013.

Today was one of the proudest days of my life. I was presented with the prestigious white coat. As I listened to the speaker I realized what a big deal receiving this coat really is. Not only does it represent numerous years of hard work in school, it represents a position of power, one that we must not take likely. When you put on a white coat people instantly see you differently. They trust you with their life. As excited as I am to finally be able to wear the white coat that I have dreamed of for years, I am a bit apprehensive. I want to make sure that I stand up to the high level that those previously have set. I never want to give the white coat a bad name.

The funny thing is that they give you the white coat on your first day of orientation. I don’t really feel like I deserve it yet. In fact I have this reoccurring nightmare that someone will see me walking around in the hospital with my white coat on and assume that I know something about treating patients. I am excited to get to wear my white coat when we start our wards experience next week but I am also pretty nervous. I am going to be spending two weeks in the department of Neurology and I know absolutely nothing about the brain…This is going to be an interesting experience. I just hope I don’t let the white coat down. I feel like that may be a reoccurring theme for me, trying not to let people down. Welcome to medical school!

white coat

First Few Weeks as a Med Student

James, First Year Medical Student“What is it like to be a medical student?” “What does a typical day look like?” “How do you balance between school and having a life?”–these are questions that I often wondered and asked when I was still a pre-med student. Unsurprisingly, I still cannot answer these questions myself at this point. In fact, sometimes I have to remind myself that I am already a medical student and I marvel at the thought that I will (almost certainly) become a physician in a couple of years. In the past three weeks, there have been times when I felt overwhelmed with what is expected of me and there have been times when I felt motivated by other students, doctors and patients. A fellow first-year student told me today that we are so fortunate to be here in medical school and I couldn’t agree more. For this reason, I will try my best to share some empowering as well as memorable moments from these past weeks.

Freshman Picnic: Entering A Christian Community

I have been in Loma Linda two times in my life. The first time was for the application interview and my girlfriend’s family brought me here. The second time is when I flew into Ontario International Airport the morning before orientation day. I was in a strange place and part of me felt excited to be independent. I pride myself on being independent at a young age since I lived away from my family about one third of my life. I was eager to explore the neighborhood around me, find out the best place to get groceries, and meet new friends.

Later that day, I went to school to try on my white coat and attended the freshman picnic. When the picnic started with a prayer, I felt a sense of peace and familiarity knowing that I am in a Seventh-Day Adventist community. It was a bit of a shock to me because I did not know that praying in an unfamiliar place with a large group of unfamiliar people actually gives me a sense of belonging. This feeling tells me that I am in a unique medical school and it is such a blessing to be spiritually connected to my peers and the faculty.

The White Coat Ceremony

During the first day of orientation, we were introduced to policies and other logistics in the student handbook as well as the numerous clubs and organizations on campus. Once again, I felt like I was back in college freshman year when I had to learn the structure of a curriculum, what was required to obtain a degree, and all the resources available to make the best out of my education.

When the day came to an end, I was excited about the White Coat Ceremony in the evening. I had already told my family that the ceremony would be online so they could watch it even when they were in Taiwan. I also told my girlfriend and my best friend who are in Washington about the live stream and I was really happy to receive texts from them saying that they were watching the ceremony.

As we lined up on the sides of the chapel and waited for our names to be called, I trembled from excitement and nervousness. I even reminded myself to walk really carefully so I wouldn’t trip on the stage! When Dr. Hadley helped me put on my coat, I struggled a little, but fortunately it did not take a significant amount of time. As I looked into the crowd, I started to wish that my family in Taiwan was looking at me on the live stream. Unfortunately, they had just moved into a new apartment and did not have internet available yet. When we returned to the stage to take the Physician’s Oath, parents started taking pictures of the students on stage and I started imagining the proud and smiling faces of each of my family members, grandparents, girlfriend, and best friend. When I saw parents and siblings waving and smiling at us, I felt like I was seeing my own family waving at me. It sounds strange but it’s true!

Symbolically, the White Coat Ceremony is the beginning of our medical professional. It helps us realize that we have chosen a career path that requires tremendous dedication and our utmost moral standards. As we all solemnly recited the oath, I felt our vigor and enthusiasm radiate across the entire chapel. Our voices said “This is the moment we have been waiting for. Starting now, we go from being cared for to taking care of others. Our hands will heal others and our words will guide the lives of many. We joyfully take on the responsibilities bestowed upon us and we will follow the example of our teachers. We will exemplify a Christ-like character in our practice and minister to all those around us with compassion and humility.”

Ward Experience: Patient-Centered Care

For the next two weeks, I spent the morning at Riverside County Region Medical Center shadowing an internal medicine team. I was amazed by how much 3rd year medical students know and how fast they learn in their rotations. They were given a number of patients that they were in charge of and they worked up the patients during pre-rounds. Part of me looks forward to the day when I am as knowledgeable and skilled as them but part of me also wonders how I will get there. Nonetheless, my partner first-year student and I tried to be as helpful as we could by grabbing charts, getting order forms, printing patient notes out, offering to help, and by staying out of the way.

Oftentimes, we could help with patients’ needs just by noticing their requests or asking them. One time, a patient wanted to have the nurse help him turn over to the other side because he was getting uncomfortable. After I spoke to a nurse, I went back and told the patient that a nurse should be coming soon. He was quite happy and thanked me for me. A small amount of gratitude such as that made me so ecstatic and I just can’t wait to do more for patients.

One assignment we had was to interview patients, listen to their feelings, and find out how their illnesses influenced them. My partner and I spoke with two patients and prayed for them. Ever since the interview, we always greeted them when we had a chance. Before we left, my partner gave one of the patients a small stuffed teddy bear in a praying posture because she said she likes to pray. She smiled was so brightly that it warmed both of our hearts.

During the pre-rounds, I also saw a medical student on our team chat with his patient and I was able to see the patient in a completely different light. She usually seemed unwilling to talk because of her discomfort. However, in the pre-rounds, the medical student joked around and laughed with the patient and I found that she is actually quite humorous. She jokingly complained about things and swore in front of us, which I find very amusing. The medical student demonstrated that physicians can definitely ease the discomfort of patients and make sure their thoughts are heard. It also helps with their cooperation. I learned a lot from the Blue (ninja) team and have added a few more people to my list of role model physicians.

Special thanks to members of the Blue Team: Dr. Chitsazan, Dr. Lewis, Vu, Kenley, Genoveva, Juan, Tiffany, Marly, and Stewart.

Medical Strategic Network Practicum: Power of Listening

On the Friday of the second week, I attended the Medical Strategic Network practicum and I was able to begin learning how to practice whole person by listening to the spiritual well-being of two patients. As I sat in a dim room on the bedside of a patient, listening to him talk about his faith, I felt the light shining on him grew brighter and warmer. I noticed the times when his eyes grew misty and his voice seemed to almost choke up. Here is a man whose faith has carried him through difficult times and given him strength when he thought he would not make it. He expressed graciousness and thankfulness to God, and I realized that he was my teacher and I was his pupil. As I sat with him, he taught me the importance of having faith despite the circumstances, the power of being listened to, and the need for me to be humble and listen to what he had to say. It was an incredible experience and the deepest conversation I have had with a person who I do not know anything about. This speaks to the unique privilege that health care providers have and the incredible effect it has on people when we truly listen to thoughts that are otherwise never told to complete strangers.

Gross Anatomy: Bodies With Stories

Just this week, actual classes have started and the gross anatomy class has always been something that I had looked forward to early this summer. When it came time for anatomy lab, we were showed something during the orientation that always came up in my mind every time I see our cadaver. We were shown letters written by the donors and one of it read:

“I want you to know that am making my final gift to mankind and leaving it to you to ensure it is delivered. Please know that the bones, muscle, the tubes, cords, and organs within me did know love, pain, hardship, and joy. My eyes have seen the beauty of this world and my feet have crossed only a small portion of its mountains and streams. My hands both gentle and strong have tried to impart comfort to the world. I revel in the memories my mind has stored and I wish I would have used my lips to smile at a stranger or a loved one a bit more often…”

Upon reading this letter, I felt sad, as if I was the donor and the hands that I used to touch my loved ones and my feet that took me to places are to be reduced to cold anatomical terms. During the lab when I studied the muscles in the suboccipital region, I spent a few seconds each looking at the arms that are still slightly pink, her shoulder that is freckled and aged, and her scalp that was shaved. I remembered that she once was alive and her body still holds her life story. She is not just a cadaver, but a teacher who has dedicated herself in a way more than all my other teachers had and I am very grateful for that.

There are a lot of thoughts to be shared because being a “student physician” requires me to see people and lives so differently. This level of involvement is unprecedented, personally, and it makes me constantly evaluate myself and think about the kind of physician I want to be. So, after being a Loma Linda medical student for three weeks, I have felt a wide spectrum of emotions from admiration and enthusiasm to feeling overwhelmed and insignificant. As far as I can tell, each of these emotions is going to feel more intense down the road! But for now, first week of classes, check!

I think… I think I know why I want to be a doctor!

Hilariously (or tragically, take your pick), I think I finally know why I want to be a doctor.

Why is it so hilaragic, you ask? What if I told you that I’ve spent hundreds of hours shadowing doctors of all sorts of specialties? What if I told you that had never considered another vocation since the beginning of high school? What if you knew that I’d attended medical school interviews all over the country, and that I passionately insisted that I knew exactly why medicine was for me in every single one? You would definitely ask me why it took me until the fourth day of medical school to actually figure it out!!

Well, it is true that I had some idea why, and those reasons are no less valid now. I still appreciate the fact that proper patient care simultaneously requires my scientific and humanistic faculties; I am still looking forward to being in a position to be a respected voice in regard to the most pressing political issue of my lifetime; and I still cannot wait to create the funkiest all-doctor band in existence. However, nothing spoke to my soul like what I experienced my first few days in medical school. And at the crux of it is that medical school is the absolute hardest thing I could ever fathom doing.

What?? Surely you knew this going in, you say. Everyone knows medical school is hard! But “everyone” thinks it’s hard for the wrong reasons. Everyone knows that you have to take lots of tests, and that you’ll have to study more than you ever have in your whole life… blah blah blah blah blah. What everyone misses is that what we medical students should strive for with every ounce of our will, what we should be shedding blood, sweat and tears for is something far beyond the realm of standardized testing.

Dr. Werner, the Dean of Medical Education, gave us first-years a talk yesterday where he precisely delineated these extra-academic goals. We must seek the utmost standard of professionalism, he implored us, and to be a professional is to be worthy of trust––the trust of the other members of our medical team as well as the most sacred trust, that of our patients and their loved ones. He demanded that we be compassionate, with universal positive regard for our patients, no matter what our biases or their behavior. There are no gomers. We must, without exception, be men and women of integrity, without respect to our pride or inconvenience or disciplinary consequences. We must also prepare to be whole physicians, always knowing that to be truly well is to be physiologically and spiritually healthy, a valuable lesson for the rigorous path that lies ahead of us as well as our future vocation as our society’s healers.

It was pretty apparent that Dr. Werner, if he wouldn’t be sued for it, would have grabbed us all, one by one by our collars and shook us until we frantically, tearfully agreed. There was no compromise in his tone. His messages were clear: this path that we are on will require us to change; the change will be an unspeakably difficult one; and the change will entail a whole lot more than how hard we will are able to hit the books. Far from it.

It occurs to me then that my journey through medical school will necessarily have to be a spiritual one. It is only through a deeply personal and emotional commitment that I believe that I can even begin to embody the qualities of the truly ethical physician. After wandering in an existential netherworld for the past year, I am invigorated by the knowledge that there is a worthy ideal to aspire to, an ideal worthy of my time and attention.

I’m not stupid. I know that what I’ve written above will sound grossly idealistic to most of you, and I suspect that those of you further along in your medical training will be especially skeptical. But somehow, getting good board scores and getting a good residency just wasn’t cutting it as sufficient motivation. I’m actually pretty sure that I will be a pretty sad sack if those were the only things I could shoot for. I’m not saying that I’m going to save the world, or be the smilingest doctor, or that my shots will feel like kisses. I’m just saying that I will try my hardest to make being a good doctor a sacred obligation, because I feel like it deserves it. Sue me if you can’t agree with that.*

*Actually please don’t.

From Acceptance to Start, It Couldn’t Be Better

“You have been accepted to Loma Linda University School of Medicine.” It’s funny how that one little sentence changes your life.  In one fell swoop you realize that everything you’ve worked so hard to achieve is finally becoming a reality and it all comes out in one big burst of grateful emotion and about a million “thank you’s” to Dr. Nyirady who waits patiently on the other end of the line while you try to recompose yourself.  I received the phone call while I was visiting family in Florida over Christmas break.  I was walking with my mom around Downtown Disney (it seems appropriate that such happy news should be delivered at the “happiest place on earth,” right?) and as soon as I hung up the phone I was immediately scooped up into a big mom hug while she simultaneously jumped up and down and proclaimed, “I’m so proud of you.”  We then proceeded to document the occasion by climbing into one of the “Disneyfied” photo booths and taking a series of silly pictures.

The hugs and smiles were even bigger and better this past Thursday as all of us incoming freshmen were given our white coats.  The ceremony was a spectacular reminder of the reason why we have all chosen to devote our lives to the profession of medicine.  Dr. Robert Orr inspired us with the challenge to be more than just medical providers and instead be the caring and compassionate healthcare professionals that God has called us to be.  Then, while friends and family looked on with beaming smiles, the white coats were distributed.  My mom stood amongst the physicians who passed white coats on to the next generation of doctors, and just as she was with me when I received the news of my acceptance, she was right there with me for this momentous occasion.  I will never forget what it felt like to have my mom help me into my first white coat.  In a word, it was perfect!   I was moved to tears as we hugged for what seemed to be an eternity and all I know is I didn’t want to let go.

The feeling was just as incredible as I made my way back to my seat and hugged my dad, his wife, my niece and nephew, my sister, her husband, and my aunt and uncle.  I knew that the white coat resting on my shoulders was the result of the values that my family had instilled in me and that this day would not have been possible without their love and support.  Once everyone had received their coats, we proceeded back up to the stage to take our oath and to dedicate ourselves to continuing the teaching and healing ministry of Christ.

The night ended with the hundreds of pictures and hugs, and just when I thought the night couldn’t get any better, my family replaced my official white coat with one that my cousins had decorated for me in honor of the ceremony.  Complete with hand-drawn stains, name badge, stethoscope, beeper, and a disclaimer on the back that warns “Student Doctor – WATCH OUT!”  It was the perfect ending to an incredible evening.

Orientation

Within the one and a half days of orientation, we met faculty, made new friends, donned our new white coats, signed up for extracurricular activities, went through the student handbooks (which is more impressive than you might think), and even got our first homework assignments. Rightfully so, for a Christian institution, those assignments were for our religion class, Orientation to Religion and Medicine.

As for all the new faces, I’m excited to get to know the administration, professors, and my classmates. I’m not very good with names, but I’m inspired by the faculty. I have already been approached and watched Dr. Lamberton, Associate Dean of Student Affairs, and Karen Schiller, Office Manager of Student Affairs, connecting the faces and names of every student. If they can do it, I can definitely try. Repetition also helps. I remembered some of my classmates from the alumni picnic and a get-together at Hulda Crooks planned by my fellow freshmen blogger Paige.

The personal connection with classmates and faculty and the school’s Christ-centered foundation are just a few of the reasons that moved me to apply to this university. LLUSM

Me and Dr. Hadley, Dean of the School of Medicine

was such a high priority for me that I chose to apply through the Early Decision Program (EDP) which only allows you to choose one school. And, I haven’t regretted my decision once.

Today, we start our Orientation to Medicine (shadowing doctors in the hospital)!

For more pictures, visit www.medschoolsurvival.wordpress.com.