2 hours ago
6
For the last four years I’ve been breaking every rule of appropriate, normal behaviour. I’ve poked, probed, inserted, stabbed and cut people in their most intimate body parts. I’ve examined dissected bodies and riffled through a bucket of human hearts. I’ve been baptised in every bodily fluid known; dodged spurting blood, spilt oozing pus and been caught out by the force of amniotic fluid erupting from a caesarean section.
Studying medicine at the age of 47, I realised in my first semester that this was not going to be like my previous experiences. Feelings of fear and ineptitude have been my almost constant companions as I was thrown into challenging situations.
At first just asking a patient about her depression seemed paralysingly inappropriate. Who was I to stumble into the private world of a stranger, when I would normally simply smile and mind my own business as we passed in the street?
She kindly tolerated my nervous questioning, becoming the first of many of my forgiving patients to say: “You’ve got to learn somehow.”
Then came the patients willing to let me stick a large needle into their vein. And the incredibly generous women who allowed me to learn how to examine their newly born babies, causing tears all round while checking for hip dysplasia.
With the onslaught of study and constantly asking patients if I could squeeze, tap, listen and feel their various body parts, I found myself becoming someone else. Searching for signs of disease through the intestines of the cadaver was just a normal Wednesday morning, and discussing how someone would prefer their death to play out was the topic for after lunch.
The transformation was most apparent the day I realised that a digital rectal examination can be life-saving. Until that point I’d seditiously protested to my fellow students that sticking your finger up the patient’s arse was bad for us and worse for them. But then a urology professor showed me how it could be minimally traumatic for the patient and clinically illuminating. The prostate was hard, lumpy and asymmetrical, and even I could immediately tell this was cancer and treatment should be expedited.
The terror continues now that I’m poised to start my first job and can no longer loudly assert that I am just a student, minimising the expectations of my colleagues and patients. I have not quite come to terms with calling myself a doctor because it sounds somewhat fraudulent.
But I also occasionally admit to myself that I am pretty thrilled about being a junior doctor at 51. I am blown away at the momentary connections I get to share with people in the most extraordinary moments of life. I am in the front row at the birth of their children, I am there when they learn of a newly discovered brain tumour. What do you say to someone faced with their own death? I can’t speak for the patients but even in my fledgling state I feel I have been able to make some small positive contributions.
And occasionally the fog of ignorance and insecurity parts for just a moment to provide a glimpse of what it might be like to be an experienced doctor. As a student I was struck one day when a seasoned paediatrician glanced at a three-second video of subtle movement of a baby in its mother’s arms and immediately diagnosed a seizure disorder with a high risk of significant lifelong consequences. I was in awe of his skill.
The experience was still just hanging on to my straining grey matter a year later in the emergency department, when I was the first to assess a baby brought in by her mother concerned about some unusual movements. She also had a short video of a momentary jerky movement. The chances of seeing this condition once were low so seeing it a second time and being able to suggest the diagnosis to my supervising doctor was maybe a fluke. But knowing I may have played a small role in getting this child treatment that could prevent a life of disability is a nice thought to hold on to.
Looking back on the four years since I resigned from my previous career as a small-town journalist, I feel a mixture of excitement, pride and exhaustion. It’s been the most stressful and anxiety-ridden episode of my adult life but also such a satisfying achievement that I feel has set me up for what is hopefully a very rewarding 20-odd years of my next career.
