Back to school today, which meant back to hospital, specifically an oncology rotation, out of town. As you may recall, my revision schedule took a bump so I was not feeling prepared or in any way competent when I walked into the big ole hospital building and blessed its airconditioning.
For once a medical school pep-talk-slash-boot-up-the-can worked on me, and I left the morning intro session feeling like I had a mission and a purpose. Maybe even some chance of passing exams in count-em-four-months. (sorry if you study with me and just puked a little at the thought)
Oncology, day one, awesome. It is said that one learns best on the margin between the zone of comfort and the zone of distress. This concept was neatly represented throughout my day. I felt comfortable enough to admit I didn’t know things, and distressed enough to actually learn them.
Well, I actually didn’t feel either particularly comfortable or particularly distressed, but the Consultant and the Registrar I am working with for the week were both very keen to get me doing things, and very keen to help me learn. Which is comforting, overall.
And then there was the moment. It was late in the day, there were just two new patients to see. So I sat down with one of them, explained my role (medical student, ask some questions about why you’re here, your medical history, some details of your life… pass that on to the doctors who will then see you…).
This was my third or fourth such consultation for the day, and I like taking histories, so I was reasonably within my comfort zone. These are not patients who will be finding out for the first time that they have cancer, so there’s not much risk of me having to break that kind of news.
This patient had undergone surgery to remove a tumour some two weeks earlier, and was not dealing well with the aftermath. She expressed some distress, there were some big big psychosocial issues, and I could see she was fixing for a cry, or more.
And so I had the moment. The one where you think “I’m not ready for this, I’m only a [insert role title here],” and you mentally cast your eyes wildly around the empty room in search of someone, anyone, more senior, more experienced, more appropriate.
But the train was on the tracks. I was on my own, and so was she.
Sure, I’m only a med student. But I’m a human and a grown-up, and I was in the room.
I won’t go into the detail, but I’m damn proud of how I got through that moment. She had the cry she needed, she told me how she felt, I listened to her story. I kept good hold of that train, and had a solid history to hand over when our time was up.
That moment, however fleeting it may be, is when you choose whether to really learn or whether to just go through the motions. I could have skipped past her ’emotional stuff’ and kept to the hard facts; I could have excused myself and asked her to wait for the registrar.
Medicine is about more than the hard facts, and if you can’t deal with the human aspects of a diagnosis, you should probably not deal with humans.
I fully acknowledge that my comfort zone tends more to the human side than the hard fact side, but it’s only ever the medicos who get to push my hard fact comfort zone. I’m used to that particular zone of distress.
I feel like I passed a test today, or cleared a hurdle. It was one that was only in my mind – for sure the patient didn’t know she was about to push me. No one else saw it happen. It’s not an assessable part of the course, though I honestly wish it was.
I’m not even entirely sure that I’ve articulated what it was that happened today. I had a moment. I squared my shoulders and reached for a box of tissues and found my way to make it work.
The hard facts and the human. I found my way to make it work.