A silly little blog for me to drop the excrement of my mind.
-or- The blessing of humanity
Published on July 13, 2004 By BlueDev In Misc
The first day on the Gynecologic Oncology service was thoroughly depressing. As medical students we were instantly put in our place at the bottom of the rank and file, stripped of any real responsibility, and relegated to running and doing inane tasks for the intern and residents. We were informed our notes were not “valid”, told that we should not sign them if we really felt the need to write them (which is fraud and something we adamantly refused to do), and not assigned any patients to follow. Rather we were instructed to arrive in the morning before the residents and just start rounding on random patients, with express instructions to make sure we didn’t “waste time” rounding on patients the residents had already seen. And we were expressly forbidden from writing notes on patients who already had a note written. Making sure they were cosigned was just too much of a hassle for the rest of the team. All in all it was a demoralizing day for all of the students involved, myself included.

The saving grace of the second day was the simple fact I was in the Operating Room all day, one of the places I truly feel at home in the hospital. However the time on the wards was still just as miserable. It was the third day that I had my epiphany. I went in to round in the morning on a particular patient on our service, a patient who really shouldn’t have been on our service in the first place (but the urology team had been completely ignoring her). As with all the patients I see I greeted her as warmly as I could, with an open smile on my face. I held her hand while I talked to her for a few minutes, I sat on the arm of the chair beside her bed, and when I left I put my hand on her shoulder. In my mind I hadn’t done anything different or unusual. But it must have been different for her.

Later, as the rest of the team went in to talk to her she greeted us as she usually had, with one exception. When she saw me she loudly proclaimed “There is my smiley face!” As I went to the OR that day I continued to think about that experience, along with the ridiculous restrictions that had been placed on us by the residents. That was when I saw the difference I could make. I could ensure that every patient I saw was treated like a good human being. That was sorely missing on the service. The residents were either too busy or too burned out to try, and the fellow, while not unkind, came across as condescending. But we, the lowly medical students, had both the time and the desire to do things a little bit differently. With so many other responsibilities stripped from us I realized we could still do something for our patients. We could help them feel valued.

I shared these thoughts with the other students and we all agreed that we would strive to do just that. We would spend the time and energy necessary to reach out to our patients and connect with them as human beings. We couldn’t take care of their medical problems, and we really weren’t given the opportunity to make any decisions in their care, but we could sincerely let them know we were there and cared for them. Every day after that I continued to be greeted as “My smiley face” by that particular patient. Every day I continued to hold her hand while I talked to her. And every day I was impressed by the healing power of kindness.

Comments
on Jul 13, 2004
I have to ask, then why do have students put in that rotation if they aren't really offered any real medical experience?

I just don't get why certain people feel the need to go for the hiearchy and make sure people are put in their place. It defeats the purpose of learning.

on Jul 13, 2004
I just don't get why certain people feel the need to go for the hiearchy and make sure people are put in their place. It defeats the purpose of learning.


I agree completely. I undertood very well what my place was. It wasn't as if this was our first rotation. What was most frustrating was coming off surgery, where I had my patients to follow. I was the person who was expected to round on the every day, to write the note for them, to develop and propose a plan for that day for that patient, and even to write orders. Of course all this was cleared through the Chief Resident and Attending, but I was expected to be the first line of medical care for my patients. And it was great. I really learned how to take care of my patients.

To be fair I did learn a lot on Gyn Onc about cancer and the different types, stages, mechanisms, and treatments of cancer. I just didn't get a chance to work on my patient care. And much of the problems stem from idiotic Medicare rules, but for some reason these only seemed a big deal on Gyn. Oh well, I learned something just as valuable and that is what really counts.