It was dark outside by the time I left the hospital. Sticky humidity hit me just as the doors opened, and I embraced the remnants of the long, hot summer’s day that I had wasted away bathed in fluorescent lights and clouds of bleach. I took a deep breath in, inhaling the scent of rows of wilted flowers, acrid gasoline, and the cigarette smoke of a few late-night stragglers. Somewhere far away, a car horn beeped, and a set of wheels skidded to a stop.

A typical Thursday night in late June.

The ache in my muscles was familiar; this was my fourth eighteen-hour shift in two weeks, and I hadn’t had a weekend off in three. I rolled my neck, trying to stretch the stiffness away — and make her voice a distant memory.

“Oh, my God. You’re so stupid. You’ve got to be the stupidest student to ever step foot in this hospital. Who let you into medical school? You’re an idiot, plain and simple.”

I try to keep walking, but her voice grows louder with each step. Soon, other voices join, creating a jumbled cacophony.

“I’m warning you now, if this patient dies while you’re on my floor, I’m blaming you”

“You’re not here to learn. You’re here to make my life easier. Now where’s my coffee?”

“But I needed you here. I don’t care what I said.  You should do what I need, not what I said.”

“Why are you such an idiot?” “How can anyone be such an idiot?” “Are you really this big an idiot?”

Idiot.

Idiot.

Idiot.

I pause on the pavement, massaging my temples. The voices fade slightly, but they are still there. They are always there, even when I’m not listening, even when I’m distracted. They’re with me with every step I take, with every patient I speak to, with every note I leave my mother on the kitchen fridge. I’m not good enough. I’m a fluke. A mistake. I’ll never be a good doctor. I’ll never make a difference in anyone’s life — at least, not a good difference. It never occurs to me not to believe the voices. These are my teachers, people I am supposed to respect and admire. People I am supposed to model my professional identity after.

And yet, through the darkness, I hear another voice.

“Don’t yell at my student. She’s new. It’s her first day.”

This, oddly enough, is a happy memory, and I smile. There is a certain pride in a medical student’s heart which swells upon being identified as someone’s medical student. It gives us a sense of purpose, a sense of belonging, during a period of time where we’re passed from hospital to hospital, from doctor to doctor (most of whom would far rather jump into an icy river than deal with a tonne-of-bricks med student). We’re uprooted as soon as we become comfortable in a place. There’s nothing, of course, to be done about it; it’s the nature of the training. No one needs to teach an expert, and, if we’re expert enough to pass the first level of board exams, then it’s time to move on. There’s so much to learn, and so little time. But it means that we’re always spectators, never belonging, never really welcome. We’re in the way. We ask questions at the wrong time. We slow things down. We step on toes. We complain.

Can you blame a physician for being hesitant to take a student?

 

I often wondered, as recently as a few months ago, how doctors could lose their compassion. Their empathy. No one is born weary, and it would be nearly impossible to get into (or through!) med school without showing compassion. Indeed, look at any group of first-year medical students. They are bright, friendly, happy, starry-eyed and bushy-tailed. What celestial force could transform them into the nightmare physicians of the future?

I know, now. I have felt it first-hand. I have been yelled at, degraded, debased so many times that it no longer affects me. At least, not that I would admit to someone, not face-to-face. And I am not the only one. I know how to comfort my friends, how hard to squeeze their shoulders, how long to let them hold in their tears before I pass them a tissue box. I know how many times you’ll fall before you don’t notice yourself tripping. I know how it feels to become jaded. These are not things we learn in classrooms. These are things we learn as the empathy is squeezed out of us, just as we will squeeze the empathy out of our students when their turn comes around. No one is born wicked. Just as no one is born a doctor.

 

I reach the edge of the pavement. One day, I will be a doctor. Will I, too, fill my days with snide comments and sarcastic retorts? Or will I be more open, yelling and swearing openly at those who incur my wrath? Perhaps I will be kind at times, and shock those around me with my uncharacteristic outbursts. Or maybe, just maybe, I will remember what it is like to be a student. And I will understand. And I will tell students that they are “mine”, comfort them, teach them, and encourage them.

How strange that would be, to encourage students! To make them feel welcome, to give them purpose and comfort. Perhaps it is idealistic to think such a teacher could exist in the chaotic world of medicine, where time is life and one second can change everything.

But I’ve seen it happen. Rarely, but it happens.

Do you think it could happen to me?

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