Reflections From Medical School: Just a Stranger on the Bus

While looking for study notes on my old computer I came across a collection of reflections I'd written quite early on in medical school. Although there was much grumbling in my medical class over having to submit reflective writing pieces, I definitely appreciate having taken the time to do this as I read back over mine now. It's so interesting to see how my perceptions of things have changed between first year medical school and first year residency! In first year I remember being: embarrassed to ask about bowel movements, mortified whenever a patient started crying, and anxious when I had to take a blood pressure...for goodness' sake. Here's a (slightly melodramatic) look back to those early days:

Just a Stranger on the Bus

            Rays of late-September sunlight flood the crowded Mount Pleasant Funeral Home as second-year Island Medical Program students read the final lines of a Johnny Hathcock poem:

Weep not for me, though I be gone.

I shall not really die.

A diverse crowd fills the hall’s wooden benches: from the wide-eyed baby sitting in his father’s lap to the elderly couple clutching Kleenex in the front row, people of all ages have gathered for the UBC Faculty of Medicine’s 2010 Donor Memorial Service.

            I stand against the wall in the overflow room to the side of the main hall, amongst a crowd of fellow first-year medical students. Their neatly pressed suits and respectful stance would not suggest the revelling of less than twelve hours past at the first-year medicine toga party. As the first lines of the medical students’ a cappella group’s Irish folksong ring out into the hall, I watch a snowy-haired couple in the second row dab their eyes. A minute of silence is observed to respect the cadaver donors.

            After twenty minutes the families shuffle slowly to the front of the hall to each receive a potted chrysanthemum and card written by a second year medical student. We watch from the overflow room, exchanging whispered thoughts on the brief ceremony. I make small talk with a fellow classmate as I try to recall his name from the 255 I have been attempting to learn over the past several weeks. Sweat beads on his forehead in the warm and crowded room; everyone complains of the heat.

            We fall silent and smile at a silver-haired lady who walks over to ask if we are “the medical students”. Her voice breaks as she tells us that her father was a doctor and that we have an amazing future ahead of us. She apologizes for being emotional and thanks us profusely; we thank her in return.

As she walks away I cannot help but wonder what she is thanking us for. Does she know that we have completed exactly three weeks of medical school? That it was only two days ago that I figured out which way my stethoscope earpieces should be facing when I put it on? Minutes later an elderly man tells me that his father is one of the donors and jokes that his dad, who never had a post-secondary education, saw donation as his chance to go to university. As was the lady who thanked us earlier, this gentleman appears to be very pleased with us.

It feels undeserved to receive such respect from strangers upon mere mention of our chosen profession. I can't help but feel overwhelmed by the social responsibility already encroaching upon us. New experiences have been coming at us quickly over the past few weeks, and we have a lot to learn between now and the day when wearing our white coats and stethoscopes no longer feels like a game of dress-up.

As we mingle in the crowded reception room, balancing paper plates of fruit and Styrofoam cups of coffee, I watch the family members, wondering who, if anyone, is here for the person we currently have wrapped in white sheets in the sub-basement anatomy lab. We know only that our cadaver is a 102-year-old female—the oldest donor this year. Any children she may have had would now be elderly themselves.

As of three weeks ago I had never seen a dead person or even attended a funeral. Then came the first day of medical school, when I found myself making an incision into a dead lady’s back with my classmates doing the same on the 52 other bodies around me. As we were told on the first day of gross anatomy, it is not normal to be in a room with 53 dead people. It seems that to avoid being unnerved by this, it is easier to regard the cadavers in the gross anatomy lab as bodies, rather than as people. With the cadaver’s face covered and body shrouded with sheets, only exposing the region currently being dissected, the uneasy student can detach the technical work from the human being in an almost surreal setting. Some students prefer it to be this way—when offered the opportunity to look at their cadaver’s face they chose not to do so. During the third lab when some of our group members decided that they were ready to see our cadaver’s face, I joined them to look upon the face of the person from whom we had the privilege of learning.

Indeed, it is a privilege to work with cadavers. Yesterday, holding our cadaver’s heart in my hands, I examined the valves and chordae tendineae—structures as perfect as those drawn in our Gray’s Anatomy textbook, even after 102 years of constant work. Being able to look at the inside of a person’s heart—an organ that has been beating through every experience in their life—is a remarkable feeling, and drew all of us closer to the lady behind the body on our table.

And so, as I stand on the crowded B-line bus headed back to UBC, I think about what I have had the privilege of experiencing over the past few weeks and about the new weight of social responsibility that accompanies. Though in gross anatomical terms I am in no way distinguished from the old man in a paint-speckled jean jacket, the Chinese lady knitting a scarf, or the skateboard-carrying teenager whose iPod I can hear from two rows away, I realize that these people may be my future patients; under the pretence of my profession I am no longer just the stranger standing beside them on the bus, but a professional whom they can trust with their problems, secrets, and perhaps even life. It is humbling to realize the confidence that complete strangers have in me, as I begin my education in this interesting field.