Hospital Tour (n): a floundering attempt to mentally memorize maze-like routes down identical hallways while speed walking pell-mell behind a guide who believes he or she is offering you a beneficial service and not a panic attack
Q&A Session (n): an opportunity to sit in panicked silence while trying to figure out what questions to ask to make you less confused without shedding too much light on your stupidity
Morning reporting time (n): 30-min before the resident tells you to come in as to budget for becoming inevitably lost in the hospital (and for every printer to shut down within walkable radius)
Scrubbing (part.): attempting to stand in a place and hold your arms in a way that doesn’t piss off the scrub nurses or contaminate yourself and others (holding them up, down, too close, and too far from you are all bad. Better to just not move. Or breathe. Even better if you have no arms).
Pre-op presentation (n): a 30-sec rundown of meds and allergies that does NOT include the cream the patient rubs on her ankles nightly for her psoriatic dermatitis, as much as you may want to report this for the sake of completion
After stuffing the 46 sheets of required logs, papers, and well-meaning informational packets into my pockets, my chief resident appears at the doorway, adorned with a scrub cap and surgical mask. My stomach drops through the floor of the cramped labor and delivery lounge. Can’t I stay with my parents (aka the clerkship directors) for a bit longer? I still have so many questions!! True, I don’t really know how to make them more specific than “can you repeat all of that again and somehow make it make sense?” which is why I huff a breath and follow the resident out into the hallway without a toddler’s I’m-holding-your-leg-forever style tantrum. She leads me and my fellow med student on service through the halls and begins talking in one run-on sentence. She could be a deep-sea diver with that kind of forced vital lung capacity. “The lounge is where you should place your things, unless you want to bring them to the ORs in B, which are 14 onward, don’t forget that, but it’s tricky to get into, although you could use the locker room code 506, which is different than the lounge code, which is 5 and 30 pressed together. You could go down this one staircase and through the offices even though it’s not technically allowed, but it’s only open certain hours, in which case you can go out and around upstairs, but if you need to go outside you can try to have someone let you in by the bush near the orange cord, but in the morning no one will be there, so you’ll have to go the third way…” What, Penn can afford a new hospital but not a sign? We’re resorting to landmarks like “bush near orange cord??”
Many turns (lost count after 10) and specific elevators I won’t remember later, we’re in the basement. It’s a flurry of activity, with dozens of staff walking purposefully along intersecting paths without colliding. Patients lie in beds separated by curtains. Double doors marked with the sign “OPERATING ROOMS” stand intimidatingly across the long rectangular room. Our resident sits us at the computer area. How is she still talking? Maybe I should take notes. Damn, I don’t have my notebook! I knew I forgot something. Maybe I can just take notes on my phone. Oh no, she’ll think I’m not listening. Maybe I can do it discreetly. But there’s no desk in front of us to shield it from view, so that’s no good. I’ll just have to remember it as best I can and write it all down after. Shit, I missed the last five minutes of information. I hope my co-med student is listening. Does my face look panicked? Let me try to make it look politely informed.
“Here, sign into EPIC and I’ll make sure you can check key things for patient prep.” My fingers scramble across the keyboard and I breathe a sigh of relief when the login page recedes: at least I remembered my password. Why does EPIC have so many tabs, though?! Surely you don’t need four tabs for medications, none of which are apparently “complete.” God, this is worse than the facilities tour. What’s that she’s pressing to get that consent form? Oh no, apparently it’s my responsibility to check that every time…what if I can’t find it!? HOW WILL I KNOW IF THERE’S CONSENT!? What about SOAP notes? We have to write those without a template tomorrow morning at 5 AM? No way I’ll finish it before rounds. “Any questions?” The cessation of the constant flow of word vomit snaps my head up. I open my mouth, then close it again. Questions are a lost cause at this point. It’ll be a miracle if I make it to day 2.
Wait a second—where did my resident go? I give myself whiplash in my haste to locate her. How did she already get all the way over there? Do residents gain the ability to apparate? I scurry off behind her with my co-med student at my side. Her gaze zeros in on me: this can’t be good. “You’ll be scrubbing this next case, so go introduce yourself to the patient in bay 2,” she barks without stopping her brisk march. I watch her drag my faithful, familiar co-med student out of my white-knuckled clutches. No, please, not my safety buddy!! Once they disappear I assess my surroundings: at least the bays are clearly labeled. No bushes or orange cords to locate. Bay 2, bay 2…I wobble over to the large “2” that identifies a bed flanked by adjacent hanging sheets. Do I just go up to the patient and start talking? Who knew such a simple instruction could cause such profound hypertension. I take a deep breath and step into the bay like it’s a stage. A young woman sits there engrossed in a book. Oh God, I don’t think she sees me. I better say something before this gets weird. I clear my throat. “Hi there, I’m the medical student on service. I’ll be present during your surgery, so I wanted to come introduce myself.” I smile in what I hope is an ingratiating manner. Wait, she can’t see that, I’m wearing a mask. Smile with the eyes, smile with the eyes. The woman looks up at me.
“Hi there. Nice to meet you.”
“Is there anything I can get you?” I ask. Laughable. As if I know where anything is located in this bestial maze.
“No, I’m ok.” She hesitates a moment. “To tell you the truth, I’m a little nervous. Ok, more like a lot nervous. I’ve never had surgery before.” Nerves, you say? Empathy: ✔. I sit on the chair next to her bed.
“Surgery is scary. But you’re in great hands, and I’ll be with you before, during, and after the procedure if you need anything.” I point to the colorful cover of her book. “How do you like it? Untamed has been on my reading list for a while.” The woman smiles at me. Her shoulders relax a little. We start to chat about the book, and—hold up—something magical seems to be happening. A smidgen of my overwhelming anxiety is ebbing away, and unless I’m mistaken, some of hers is too. For the first time today I feel a glimmer of hope: maybe I’ll make it to day 2 after all.
I suppose I’m now irrefutable evidence of living miracles because day 2 became day 254 and counting. Some may insist that now first days are a breeze, that we saunter onto the wards with the cool aplomb of seasoned veterans; I think that’s bullshit—well, maybe my more competent peers do, but I certainly don’t. I still feel nervous before the first day of a new rotation, but in a distinctly different way than that first beginning in January. It boils down to being comfortable being uncomfortable. The ambiguity of life on the wards doesn’t seem insurmountably daunting anymore. It’s that feeling you get when you go back to your elementary school years later and everything—the buildings, the desks, the playground—looks smaller. It hasn’t really shrunken, you’ve just grown. I don’t have to know everything to be comfortable – I’m confident that I’ll figure it out as I go. Sometimes when the residents change services and the med students remain I find myself no longer the most clueless team member, but the temporary foremost authority on my patients and their most invested advocate. Above all, these past 8 months I’ve learned that medicine, at its very core, is about people. If I can connect with people about the smallest of things, even if it’s just the book they’re reading, I know I’m doing something right. Even if I still can’t find the GYN lounge.
Image by Tracy Du, an MS2 at the Perelman School of Medicine.
