Tag Archives: medical student

Kacper Niburski is a medical student in the Class of 2021 at McGill University. He is also the CMAJ student humanities blog editor.

 

 


The heart is open and I wonder if my feet smell. Much of the room seems too busy to notice. The surgeon is making a joke about the shaky season of the Toronto Maple Leafs. The attendants laugh in unison. The perfusionists look to their dials, turn one, turn off another, and gaze my way with a nod. Do they smell it too?

Two hours earlier held no scent. The morning swam with sun. I arrived early to the Hospital to shadow the lead cardiac surgeon. I was told via email to dress light. To arrive early. To be ready.

I was. The night before saw me donned in recycled papers of anatomy, reviewing structure after structure, medication after medication. Any heart sound I’d be prepared to listen to knowingly. Any condition studied could be recited as though from a pleasant dream too pleasurable to forget.

I try to share that pleasure now. I smile back, failing to remember that my face is blocked with a mask. My clothes too have been changed. I am adorned in green, a naïve look against the shadow of yesterday. Only my socks stick out of their wrapping. They look like a left-over meal stuck in a fridge too long.

The surgeon makes another joke. Another chorus of chuckles follow. Blood is pooling out of the myocardium. “Suction please.” The whirl drowns out the sounds while the heart suffocates with air.

When I met the surgeon, I seemed to do the same. I whispered my name while shaking his hand. Then I sat quiet while the cardiologists spoke. The case was difficult. The 42-day old child had a type b coarctation, aortic stenosis, and now, only presenting the day of the surgery, a hematoma. One as large as the left ventricle. One as large as a life.

What would you do, the surgeon asked a cardiologist in the room. I am not sure, she replied. In thirty-one years, I haven’t seen anything like this. That shit is scary. The black mark on the screen seemed to absorb the light and the conversation. They all stared at it in silence.

The OR bursts in another bustle of laughter as the extracorporeal membrane oxygenation begins to tumble. The heart now pauses to a near standstill. Each beat appears forced, slow. I take twelve breathes before each one. I take another ten sniffs. The smell is getting stronger. I take nine the next cycle. Stronger yet. Eight the one after.

Meanwhile, the hands heave life. The surgeon is busy cutting and stitching and suturing and joking and cutting again. Bits of flesh fly into the vacuum. One hour passes. And the smell only worsens.

What could it be? I changed my socks. Washed my feet. My boots were new too. But in the morning, one of the cardiologists told me I could not wear them. Salt ate away at their integrity.

They were not allowed in the OR. You’d have to go in your socks, he said. He was wearing unblemished leather shoes.

With them, we walked to see some of his morning patients. Each case was riddled with complexity. Dr. K, is the heart rate stable? Dr. K, what was the correct dosage applied? Dr. K. Dr. K. Dr. K. His name was called everywhere while I stood beside him like a lost dog. My name was not asked once. Only until after my feet hurt and I was lost in a stew of medication names was I called. Kacper, I was told, this is the room. This is the patient who will have the surgery.

The room was thick with a deep, hugging black. The parents were huddled over a small incubator. From the doorway, they looked like stars.

The light of the OR is aggressive now. It weeps it. I think of them and that idea – the family as stars, celestial bodies watching the world. At first, I was comforted by it. I was brought back to period faraway from this standing where I was sitting in a canoe, trees whispering around, unshoed like I am now, and looking at a universe that could not look back. I could recognize the beauty. I could become it too.

But now, standing on my toes, trying to get a better view of each slice, watching as the screen is tipped forward and then away in a window of opportunity no larger than bundle of grapes about to ripen, I am reminded that stars are long since dead. They are no more. Only their light is forced to stay. The heart hasn’t beat in a while.

What will happen? I try to think, but I am nervous. I shift heel to heel. The wrong facts come back from the bridge to yesterday’s nowhere, to when I studied under the silence of a life. Move around, excite the sympathetic nervous system, get more blood from the heart, heat the body, sweat more. I spell out the conclusion once more in my head.

I try to stop moving in a dry attempt at survival, but these simple watered-down facts make me more anxious. Maybe the smell is me, I begin to think. Maybe I have reached a threshold of no return. Maybe I cannot stop sweating now and I will become a pool of water. First at my feet. Then my knees. I will get shorter and shorter, soon seeping into these white floors, climbing up the exhaustion of a lifetime, extinguishing these expensive machines, filling up the closed room in a smell that cannot be avoided now, that was all that was, all that is, all that will –

I am tapped on the shoulder. Dr. K asks how I am doing. I tell him okay. Pretty interesting, eh? Absolutely, I answer in what I imagine sinking sounds like.

 


Note: This is a work of fiction. Any resemblance to actual people, living or dead, is purely coincidental, similar to how a flower described here would not smell as good as the real.

Noémie La Haye-Caty is a medical student in the Class of 2019 at McGill University

 

Katy is sleeping on the exam table. She came in looking tired, talking with a weak voice, and walking with small steps. I tried to ask a few questions, but her lack of sleep was evidently preventing her from answering.

She is here today for a follow-up appointment. She was admitted two weeks ago because she wanted to end her life.

I try to gently wake her up. “How are you doing, Katy?”

“Better.”

“Great! What’s better?”

“I was confused, before.”

“Why were you confused?”

Katy is 24 years old and has three young children. She is now a few weeks pregnant. Two of her children were recently taken by the Director of Youth Protection (DYP), while the youngest lives with Katy and Katy’s own mother. Katy tells me that the father of her kids used to be violent with her and has been in prison for the past week. ...continue reading

Danielle Penney is a medical student in the Class of 2021 at McMaster University

 

“Doctors are jerks.” It was a statement that I had always steadfastly believed to be true; a matter-of-fact statement, just like saying the sky is blue. Though I had no shortage of concrete personal examples to justify my belief, the irony was not lost on me as I stared out from behind the glass of the nursing station, ready to begin my first clinical experience as a new medical student.

I was in the child and adolescent psychiatric ward. From the nursing station, I could see the ward’s common area: the bolted-down tables and chairs, the colourful pictures adorning the walls, the patients scattered about the room—some in groups, some alone. It was a scene that was familiar, yet different. This was far from my first time in a psych ward, but it was my first time being on this side of the glass. ...continue reading

Maggie Hulbert is a medical student in the Class of 2020 at Queen's University

 

First Year Out: A Transition Story
(Singing Dragon, 2017)

Earlier this fall, over the course of a tense dinner table discussion, it came to light that a dear relative of mine held some blatantly transphobic beliefs. I was greatly distressed by this — not only because these beliefs were at complete odds with my own, but because I had no idea what to do. I felt that it was my responsibility to educate them and keep communication channels open... but having had little success with blunt confrontation, I was at a loss.

Then I read First Year Out: A Transition Story, the second graphic novel by Vancouver-based author Sabrina Symington. First Year Out describes the story of Lily in her first year as an openly trans woman, and covers everything in Lily’s life from the basics (such as how she gets dressed and her first experience with online dating) to the harder conversations (like confronting her mother about her TERF [trans-exclusionary radical feminism] attitude and telling her boyfriend that she wants sexual reassignment surgery). Through the incredible medium of graphic story-telling, we get to literally see how Lily grows into herself. ...continue reading

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Rashi Hiranandani is a medical student in the Class of 2019 at the University of Ottawa

 

Medical school is a stressful time in students’ lives. There are emotional, physical, and mental stressors; particular daunting is the stress of being in new clinical environments on a weekly or even daily basis and having patients’ lives in our hands. Medical students are sleep deprived and over-worked. We have the stress of not matching to the residency of our choice or even not matching to a residency program at all.  Medical students also experience significant burnout and compassion fatigue, with burnout rates ranging from 27 to 75% [1]. It thus comes as no surprise that medical students suffer from rates of mental illness higher than the general population. This is not ideal for the health of the medical students, nor is it optimal for the health of the patients they care for.

A 2016 systematic review published in JAMA reported that, on average, 27.2% of medical students deal with depression or depressive symptoms [2]. Among students who suffer from depression, only 16% receive help [2]. ...continue reading

Welcome to this week's edition of Dear Dr. Horton. Send the anonymous questions that keep you up at night to a real former Dean of Medical Student Affairs, Dr. Jillian Horton, and get the perspective you need with no fear of judgment. Submit your questions anonymously through this form, and if your question is appropriate for the column, expect an answer within a few weeks!

Dear Dr. Horton,

Over the past month, much of what is occurring in our political and social climate has been serving as a constant reminder of inappropriate behaviours/sexual harassment I've experienced as both a patient and a medical learner.

Do you have any advice in navigating these feelings?

Signed,

Demoralized

...continue reading

Kacper Niburski is a medical student in the Class of 2021 at McGill University.

 

There are only a few bodies that I have touched fully and fumblingly: my mother’s, as a baby drawn to a life that spills kindness; my twin’s, as a faulty scanner realizing that meaning is not found in mirrors; my lovers’, who have known that fingers loiter like summer horizons when undressing the lightness of being. I’ve hugged big bodies, mountains of men and women. I’ve stretched to bodies that have slipped away, that have asked for my palms to leave. And I have felt the bodies that whispered into a night that saw everything that this is what it was all about — to hold and be held, to love and be loved.

Sometimes, in the steep silence after these uneven affairs, there are heartbeats. Tiny, repetitive things that almost seem too quiet to be, but are. There, under your nail. There, in my own now. They bumble braveness. They tickle familiar muscles and call like sunlit laughter. Against the unseen quiet, their sacredness spools out in a language older than language itself. ...continue reading

Serena Arora is a medical student in the Class of 2019 at McMaster University

 

I love puzzles.

I love looking at the picture on the box, seeing what the completed version will look like and then pouring out all the little pieces — knowing that, somehow, they all come together to create something.

In some ways, practicing medicine is like doing a puzzle. It’s complex, intersecting, and incredibly rewarding when done right. At the same time, medicine is fractured into a thousand different components.  As physicians, we look at our patients and we piece them apart into organs and body systems and tissues. We rip the details we think are important from the fabric of their narrative to focus on specific complaints. We take their words and distill them into our jargon, often so much so that their original story would be unrecognizable. Medicine is often an act of reductionism.

If medicine is a puzzle, then palliative care is like the picture on the box. ...continue reading

1 Comment

Welcome to this week's edition of Dear Dr. Horton! Send the anonymous questions that keep you up at night to a real former Dean of Medical Student Affairs, Dr. Jillian Horton, and get the perspective you need with no fear of judgment. Submit your questions anonymously through this form, and if your question is appropriate for the column, expect an answer within a few weeks!

Dear Dr. Horton,

It seems everyone is always talking about the importance of having a strong support system around you. While I’ve managed to make casual acquaintances among the pool of colleagues and co-learners I see from time to time, these relationships feel fairly superficial. Yet no one seems to have the time to forge deeper connections...

How do you build your "tribe" in medicine, given how busy everyone is?

Signed,

Lone Wolf

...continue reading

Yipeng Ge is a medical student in the Class of 2020 at the University of Ottawa

 

Humbled. I am so truly humbled that I get to work with and learn from so many passionate medical students with such strong and refined values, morals, and dedication to their causes.

I am specifically speaking about the shift in the medical learner community to respond more attentively and compassionately; to acknowledge the importance of health and social inequities as they affect and inform our medical education and profession, and — more importantly — how they ultimately affect our current and future patients. Patients do not experience the health system not as an isolated entity (though for many of us in the healthcare field, it can certainly feel as though our assistance is limited to clinic rooms); instead, they are affected by the many determinants of health and wellbeing beyond the direct control and impact of clinicians in the healthcare setting. ...continue reading