It’s 6:45 am on a random Wednesday in July and I’m wearing the wrong size scrubs to shadow on the Labor & Delivery floor. Too-big top and too-small pants. The combination is dreadful. I am a formless light blue bedsheet billowing down the South Street Bridge, sweating hard in the heat that feels illegal this early in the morning. My back, I feel, has already turned a distinctly darker shade of blue, a fact I confirm to much chagrin fifteen minutes later in the busy residents’ room on Ravdin 7, as I toss my backpack in the corner and try to occupy as little space as possible. My heart is pounding. I look a mess. I don’t know who the attending is and at this point I’m too afraid to ask. Where do I stand so I’m not in the way? I wish my scrubs fit better.
As the weary overnight team signs out their patients to the day shift, I plaster myself to the wall, wishing to be endocytosed by the drab cinder blocks.
In retrospect, I may have set expectations too high for my scrub-clad clinical debut. Blame it on the pandemic and our lack of in-person anatomy, I guess. I’d worn scrubs here and there for ICM and some outpatient shadowing, but presenting myself to an inpatient floor at HUP, decked out in the whole uniform (Patagonia and all), had seemed to me an important milestone. Year one at Penn had been transformative to be sure, but preclinical is prologue. Preclinical. The opener to the main event. The theory behind the practice. The rollercoaster chugs steadily skywards and we prepare to drop. It’s a year and a half of investment into our future clinical selves, shaping us into bright-eyed clinical students who enter the hospital, minds brimming with pathophysiologic mechanisms, their manifestations, and treatments, ready to earn our place in the medical hierarchy. I don’t see much of that student doctor in myself yet, but I’m eager to meet her – and the one thing I know about her is that she wears scrubs. In some circuitous way, then, to don my first pair of scrubs is to meet my future self. It is to assure myself that, amidst all my imposter syndrome and self-doubt, I am ready for what lies beyond the prologue.
Well. If that anxious summer morning was a sneak preview into my clinical future, it was a rather grim one. I will admit to a slight tendency to catastrophize, and this scrub-related freak-out was no different. My day on Ravdin 7 was a highlight of my summer; I witnessed three uncomplicated births and cried at all three, thankful for the layers of PPE that shielded my unexpected emotions from the rest of the delivery room. But there was that feeling that I couldn’t shake, as I went home after the shift and shoved that pair of scrubs heartlessly into the depths of my closet. It was a spooky feeling of discomfort in my own skin and, by proxy, discomfort in my professional identity.
The light blue scrubs mark my entry into clinical medicine. What if I don’t wear them well?
This question weighed on my mind so heavily that, a few days later, I find myself standing in front of my full-length mirror, trying on pair after pair of scrubs. This is the third set I’ve swiped from HUP. I turn the waistband of the pants into a de facto corset, yanking the frayed yellow ties as tight as they’ll physically go and picturing my internal organs plastered up unhappily against my body wall. The pantlegs hang loose just above my ankles. Hold my breath, tie a neat little bow, and exhale to see my handiwork.
It could be worse, I suppose. The waistband sits practically at my sternum, but there is no weird marsupial-like pouch. The top is fine. Tucking it into the pants helps a bit. I surveil myself critically in the mirror, hoping it’s enough to erase my first experience from memory and redo my botched clinical debut. Preclinical Julia, meet the older, wiser, and much cooler clinical Julia.
Well, here I am, scrub-clad in my bedroom, and a shapeshifter I am not. Peering back at me in the mirror is, well, me – 23 years old with tired eyes and hair I probably should’ve washed, dressed in what looks more like a Halloween costume in desperate need of ironing than symbolic garb laden with significance. As if sized-up pants and a sized-down top would somehow make me look – or feel – the part. On a scale from 1-10, with 1 being toga party attendee and 10 being an elite medical professional… well, you get it. I drape my stethoscope across my shoulders, bundle up in my Patagonia, and even toss on a surgical mask, but to no avail. I do not find reassurance in my full-length mirror.
I replace the scrubs with sweatpants and go back to studying. The prologue persists. How embarrassing, this silly game of dress-up.
Fast forward a few weeks and our second-year fall barrels forward at full force. The countdown to “The Wards” is inescapable and brings with it a meteoric rise in ICM sessions and ultrasound practice and opportunities to engage in inpatient work. Read: more opportunities to wear scrubs. All that luxurious time I had over the summer, to stand in front of my mirror and deeply overthink how I look and who I am and what it all means, is gone, replaced by cursory glances before leaving for JMEC in the morning. It’s a welcome change, to think less. To criticize myself less.
At some point in the fall, I’m in a patient room and catch a glance of myself in the mirror that hangs on the back of the door. Pause. She is unfamiliar at first, but the longer I stare the more I am anchored in the familiarity of my glasses, my hair (pinned back in a low ponytail that looks very… founding father), and the tiny gold earrings that peek out from behind the loops of my mask. Same light blue scrubs and standard-issue grey jacket. Between the PPE, my ID that screams “MEDICAL STUDENT” at the top of its lungs, and the stethoscope peeking out of my jacket pocket, I am surprised by how much I look – and feel – the part.
I don’t linger at the mirror too long this time. There is information to gather from the patient. But I burn the image into my mind and file it away. Since then, as our preclinical prologue comes quickly to an end, I’ve thought a lot about the student doctor I’ll become in a few short weeks.
I haven’t met her yet. But I think I’ve seen her around.
Julia Gasior is an MS2 at the Perelman School of Medicine.
Image by Tracy Du, an MS2 at the Perelman School of Medicine.
