Tonight I take on the identity of Physician.<\/em> It was surreal.<\/p>\n\u201cHi Jennifer,\u201d the classmate I\u2019d sat with during that morning\u2019s orientation lecture waved and bounded over to me.\u00a0 She wore a grey skirt suit and had her hair pinned into a serious-looking bun at the back of her head.\u00a0 Her wide eyes and huge grin betrayed her little-girl excitement despite her effort to look professional.\u00a0 She was an honors graduate from one of the Ivy-League schools\u2026Brown? Dartmouth? Her alma mater\u2014and her name\u2014evaporated from my memory.<\/p>\n
\u201cHi\u2026\u201d I smiled back at her. Oh God, what\u2019s your name?<\/em><\/p>\n\u201cSo, what do you think will happen tonight?\u201d Miss Ivy-League half-whispered.<\/p>\n
\u201cI don\u2019t know.\u00a0 Seems like an initiation of sorts.\u201d Name...? Ugh, does it start with a \u201cP\u201d?<\/em><\/p>\n\u201cA rite of passage\u2014yeah, that makes sense,\u201d her grin faded reverently.<\/p>\n
\u201cLooks like we\u2019re really going to be doctors someday,\u201d I said, trying to sound reverent, too. Peggy? Patty? Shit!<\/em><\/p>\n\u201cI know.\u00a0 Can you believe it?\u00a0 And we\u2019re at Pritzker!\u201d She giggled nervously, returning to her excited grin, \u201cDid you know 6,000 people applied for our class of 114?\u201d<\/p>\n
\u201cWow.\u00a0 I didn\u2019t realize that.\u201d 6000 applications?? How the hell did I get in here? <\/em><\/p>\nWe both glanced around the room, studying our classmates.<\/p>\n
\u201cThere must be some amazing people here.\u00a0 I have no idea how I got in,\u201d said my nameless future colleague, giggling again.<\/p>\n
I smiled at her, \u201cI was just thinking the same thing.\u201d Do we all feel this way?<\/em><\/p>\nOur shared moment of self-doubt was interrupted by the announcement that the ceremony was about to begin.\u00a0 We made our way to one end of the hall, towards a low plywood stage with five rows of plastic folding chairs for the medical students and participating faculty. I took a seat in the second row near the heavy mahogany lectern adorned with the University seal. Tonight I take on the identity of Physician. <\/em>My internal mantra continued, as if I was trying to convince myself. The fifteen rows of folding chairs facing our stage were now filling up with family and faculty. Single and far away from home, I had no family in the audience.\u00a0 Bathed in the gaze of those beaming strangers\u2019 faces, I fleetingly became a small, lost child. The loneliness ached far below my smiling excitement, but I didn\u2019t let it show.<\/p>\nThe purpose of this ceremony was to formally welcome us medical students into the ranks of physicians.\u00a0 We were to be called up individually and given our white coats (a gift from the school) and a stethoscope (a gift from a medical equipment company). As the white coat slipped onto my shoulders, I would be admitted into an exclusive club of healers who serve at the highest level of knowledge and responsibility.\u00a0 By accepting that coat, I would commit to seeing a long, difficult journey through to its still-murky destination.\u00a0 I also committed to traveling that road with dedication to excellence.<\/p>\n
We settled into our seats, and the ceremony began. Speeches about our shining futures and the importance of our chosen path wafted over me. I was pleasantly basking in the glow of my glorious potential when I was abruptly jarred by the Medical School Dean\u2019s deeply resonant voice, \u201c \u2026 as you fulfill your calling\u2026\u201d My calling??? <\/em>I knew that I was interested in science and that I had a desire to work with people rather than alone in a lab. To me, medicine seemed like a good fit for my strengths and preferences in a career.\u00a0 It made a lot of sense to me. But was it a calling<\/em>?\u00a0 Probably not. Was that required?\u00a0 I hoped not.\u00a0 I hoped that it would be enough for me to want to use my talents in the service of fellow human beings.<\/p>\nDad was disappointed in my choice. Maybe I shouldn\u2019t be here.<\/em> My thoughts drifted back to that painful phone call two years earlier. Until my junior year of college, I had been planning to get a PhD in genetics.\u00a0 My father, a brilliant man who had not had the opportunity to go to graduate school, was very enthusiastic about my PhD plan. It appealed to his sense of intellectual hierarchy\u2014the PhD is the most advanced degree, and that seemed like just the right level of accomplishment for me, his highly accomplished oldest daughter.\u00a0 He loved the idea that I would be \u201cDr. Hasenyager\u201d, the first person in our family to earn a PhD.<\/p>\nAs I dialed nervously, ready to tell him my news, I knew he would be surprised by my change in career plans.\u00a0 What I didn\u2019t expect, however, was the lasting impact of his words:<\/p>\n
\u201cHi Daddy,\u201d<\/p>\n
\u201cHello!\u00a0 How\u2019s my girl?\u201d<\/p>\n
\u201cI\u2019m good.\u00a0 I have some news for you,\u201d<\/p>\n
\u201cOK.\u00a0 What\u2019s your news?\u201d<\/p>\n
\u201cI\u2019ve decided to go to medical school instead of getting a PhD.\u00a0 I learned a lot working in the lab this summer, but it was really lonely and isolating. I want to work with people.\u00a0 Medicine combines science and people.\u201d<\/p>\n
Dad was briefly silent, and then I heard his controlled inhale as he prepared to speak.\u00a0 \u201cYou know, Jennifer, medicine isn\u2019t really science.\u201d He was matter-of-fact, almost chatty.<\/p>\n
His casual disapproval sucked the breath out of my body and scattered my carefully constructed pyramid of logic like a house of cards. Medicine isn\u2019t science? It isn\u2019t good enough for him? <\/em>Stunned, I somehow gathered my words back together and mumbled, \u201cMD\u2019s can do research just like PhD\u2019s, Dad.\u201d\u00a0 I then lamely tacked on,\u00a0 \u201cI\u2019ll still be Dr. Hasenyager.\u201d\u00a0 The tense conversation didn\u2019t last much longer, and <\/em>my Dad never repeated his initial disapproving remark about medicine.\u00a0 Despite his rapid shift to supporting me, his early and honest reaction sewed the seeds of doubt that were in full bloom as my attention returned to the White Coat Ceremony.<\/p>\nDo I belong here?<\/em><\/p>\n\u00a0<\/em>I shifted in my wobbly chair, listening to the slow reading of our 114 names. I watched classmates summoned in turn to receive their white coat.\u00a0 Returning to their seats, some of them were shining with pride.\u00a0 Some of them were scared to death.\u00a0 Many looked as if they didn\u2019t quite inhabit their coats.\u00a0 A few seemed completely comfortable.\u00a0 One classmate was oddly blank\u2014as if he were numb.<\/p>\n<\/em><\/p>\nLulled by the monotonous ceremony, I drifted into another memory from just a few months before:<\/p>\n
I was trying to read my smutty historic novel, passing the time on a flight back from Chicago to New York during the spring of my senior year of college. \u00a0I\u2019d been visiting the University of Chicago campus as an accepted medical student and was returning to Cornell to finish the last few weeks of classes. During my visit in Chicago, I had struggled to imagine myself walking the halls of the hospital dressed in scrubs and a white coat, on my way to take care of a patient.\u00a0 Until that visit, I\u2019d been focused solely on getting into medical school.\u00a0 Now I was contending with the reality that I was about to become a physician.\u00a0 I read the same paragraph in my book several times over, unable to concentrate on the heroine\u2019s imminent deflowering\u2014consumed instead with the mystery of my life as a doctor.<\/p>\n
DING DING DING DING.\u00a0 I looked up from my book and saw, twenty rows ahead of me, a person\u2019s hand reaching up to the flight attendants\u2019 call button, pushing it over and over again.\u00a0 I\u2019d never seen that before.\u00a0 I certainly never pushed that button.\u00a0 I\u2019d always put flight attendant call buttons in the same \u201cemergency only\u201d category as fire alarms and red STOP buttons in elevators.\u00a0 And I definitely would never consider pressing it repeatedly.<\/p>\n
DING DING DING DING.\u00a0 Wow, this person\u2019s persistent.\u00a0 They must really want another Coke.<\/em><\/p>\nI tried to go back to my reading.<\/p>\n
\u201cMay I have your attention please, is there a doctor on the plane?\u201d The flight attendant\u2019s voice was clipped and tense, \u201cIf so, please ring your call button and identify yourself.\u201d<\/p>\n
My head snapped back up.\u00a0 I looked to the front of the plane, where the call button had been ringing.\u00a0 There were two flight attendants standing in the aisle, lifting an unconscious passenger out of his seat and to the floor.\u00a0 I couldn\u2019t see much else from my where I was sitting, but I could tell they were starting CPR.<\/p>\n
\u201cWe have a medical emergency on the plane.\u201d The carefully controlled voice explained, \u201cPlease remain in your seats.\u00a0 If there is a doctor on board, please identify yourself.\u201d<\/p>\n
Thank God I\u2019m not a doctor yet. <\/em><\/p>\nThe stunningly true thought slipped through my thin veneer of pre-med confidence too quickly for me to deny it.<\/p>\n
No one\u2019s ringing their button. <\/em><\/p>\nI watched a tall man in a flannel shirt stand up and move forward down the aisle.<\/p>\n
Is he a doctor?\u00a0 He doesn\u2019t look like one.\u00a0 What\u2019s wrong with that guy?\u00a0 Did he have a stroke?\u00a0 A heart attack? <\/em><\/p>\nNo one else seemed to be crying or upset, and so I assumed that this sick passenger was traveling alone\u2014dying alone.\u00a0 I was certain that he was dying.<\/p>\n
Oh my God, next time I hear someone call for a doctor, I\u2019ll be on the hook.\u00a0 A life will be in my hands.\u00a0 What the hell am I getting myself into?\u00a0 I don\u2019t want this.\u00a0 What if I can\u2019t save him?\u00a0 What if I don\u2019t know what to do? <\/em><\/p>\nI watched the guy in the flannel shirt take over the chest compressions for the flight attendant.\u00a0 I didn\u2019t even know that they were called chest compressions then. I watched flannel shirt guy do CPR while the flight attendants got the cabin ready for landing.\u00a0 I couldn\u2019t stop watching.<\/p>\n
Thank God that\u2019s not me. What\u2019s wrong with me?\u00a0 I should want to help. Oh, thank God that\u2019s not me.<\/em><\/p>\nThe chattering voice in my head went on incessantly.\u00a0 I was breathing fast, my chest tight and heart pounding up into my throat.\u00a0 I couldn\u2019t look away from the increasingly hopeless resuscitation\u2014none of us could.\u00a0 As we landed, we were all instructed to remain in our seats until the ambulance crew arrived.\u00a0 As the poor dead man was rolled off the plane, I wondered how the guy in flannel was doing.\u00a0 He\u2019d just been working on a dead guy for more than an hour.<\/p>\n
That will be me next time.\u00a0 What am I signing up for? <\/em><\/p>\nI\u2019d been deeply ashamed of my panicky reaction on that plane and had never mentioned how I felt to anyone.<\/p>\n
I tuned back in to the ceremony, noting that my name would be called soon. Do I want to do this work for the right reasons?\u00a0 Is it OK that I chose medicine because it seems that I\u2019ll enjoy it and be good at it?\u00a0 What about helping others and doing good in the world? Am I altruistic enough? <\/em><\/p>\nWhat about my classmates who speak of their lifelong wish to help others?\u00a0 Do they deserve this white coat more than me?\u00a0 Or the classmates who say they\u2019re just following in a parent\u2019s footsteps?\u00a0 Do I deserve that coat more than them because they don\u2019t even seem to want this job? <\/em><\/p>\nThe ceremony again required my attention\u2014it was my turn to go forward and assume the mantle of my chosen profession.<\/p>\n
As I walked up and received my coat and stethoscope, all of the chatter in my head was quiet.\u00a0 I saw the faces of other people\u2019s families looking at me with respect.\u00a0 I felt the slight weight of the coat on my shoulders and the heavier weight of the stethoscope in my hand.\u00a0 I was different with the coat on.\u00a0 Every person in that audience viewed me as a physician in that moment.\u00a0 Every person who saw me wear that white coat from then on would view me as a physician.\u00a0 I began to feel the power of the coat.\u00a0 And I began to feel the responsibility.\u00a0 It didn\u2019t feel like college any more.<\/p>\n
I can do this.\u00a0 I deserve to be here. Tonight, I take on the Identity of Physician.<\/em><\/p>\nI straightened my shoulders and, for the first time, I pretended to feel confident in my white coat.<\/p>\n
Gross Anatomy and Grandma Anna<\/strong><\/p>\nGross Anatomy is a rite of passage so universal in medical training it has become a clich\u00e9.\u00a0 There is good reason for the course\u2019s fame\u2014it is a profoundly altering experience to take apart a human body.\u00a0 Our gross anatomy lab was located on the first floor of one of the biology buildings on the main campus\u2014not in the medical center.\u00a0 It was in one of the old stone buildings, and the huge windows were all painted black so no one could see inside from the nice courtyard lawn on the other side of the wall.\u00a0 We worked in teams of four first-year medical students, and I had a good team:\u00a0 Two women, two men.\u00a0 Two leaders (me and one of the guys) and two followers.\u00a0 No budding surgeon who insisted on doing all of the \u201cwork\u201d (I didn\u2019t yet know I would become a surgeon).\u00a0 Two quick-studies and two more sedate in their pace.\u00a0 We all got along very well, which was not true of some of our neighboring teams in the lab.\u00a0 Each team was assigned a cadaver (a dead body) for the six-month course.\u00a0 The lab was large with very high ceilings, a linoleum floor, and about two dozen waist-high stainless steel tables just large enough to fit one person lying down.\u00a0 On the day we first \u201cmet\u201d our cadavers, we all walked into the lab and found our team\u2019s assigned table upon which lay a human body inside a plastic body bag\u2014just like the morgue on TV.\u00a0 With the bodies in the room, we were introduced to the odor of the chemical preservative that was necessary to prevent decomposition.\u00a0 It was the sort of odor that got into your nose, soaked into your hair and clothes, and imprinted itself on your brain forever.\u00a0 We all kept a set of scrubs in lockers at the lab building.\u00a0 The scrubs were necessary not so much because what we were doing was so messy, but because we didn\u2019t want that smell on our clothes and in our homes.<\/p>\n
On the first day of anatomy lab, our main task was to unzip the bag and look.\u00a0 We were also given the information cards that come along with each cadaver.\u00a0 On the card is recorded the age, gender, and cause of death.\u00a0 That\u2019s it.\u00a0 No name.\u00a0 No story.\u00a0 Our cadaver was a man in his 70\u2019s who died from sepsis.\u00a0 I had never heard of sepsis, but I learned very soon that sepsis means overwhelming infection in the blood\u2014usually from bacteria.<\/p>\n
When we unzipped our bag, we saw that our cadaver\u2019s head was wrapped in large pieces of cloth, as were his hands.\u00a0 The rest of him was naked\u2014no hospital gowns needed in anatomy lab.\u00a0 Near the end of the first lab period, we were instructed to unwrap our cadaver\u2019s head.\u00a0 He had a full beard, a bald head, and a sharp, prominent nose that was flanked by bushy eyebrows and deep-set blue eyes.\u00a0 His expression was peaceful.\u00a0 And his brain was missing\u2014standard procedure for cadaver preparation, apparently.<\/p>\n
Before that day, I\u2019d wondered if I might be upset seeing a dead person for the first time. Surprisingly, I felt pretty good\u2014curious and calm with just a touch of queasy nerves. In retrospect, I realize that I was soothed through that first exposure to human death in part by the church-like reverence of the old lab space. I unknowingly sensed my place in the solemn dignity of that room\u2019s past, present, and future.\u00a0 As I left the lab, I wondered if I might be upset cutting our cadaver for the first time. I soon learned that the first incision is easy.<\/p>\n
The day we began our first dissection, we were instructed to turn over our cadavers so their backs were facing the ceiling.\u00a0 Each team was then given a copy of the dissection manual that would lead us through every step we were to take for each class.\u00a0 The manuals were dog-eared spiral-bound books that had seen many years of use, and they were indelibly infused with the anatomy lab smell.\u00a0 No way those books would ever be brought home for studying.<\/p>\n
The very first dissection was of the muscles of the upper back and shoulders.\u00a0 Someone on each team needed to be the first one to pick up a scalpel and make an incision as illustrated in our manuals.\u00a0 To be honest, I can\u2019t remember who on our team made the first incision\u2014I don\u2019t think it was me, though.\u00a0 I do know that I took part in that first dissection and that I was so fascinated by the truly extraordinary structure of the human body\u2014even back muscles and nerves\u2014that I lost awareness of the fact that this had very recently been a living, breathing human being.\u00a0 At the end of that first lab session, the four of us on the lab team had bonded together in an act of extraordinary intimacy and privilege, and we knew it.\u00a0 I felt energized by the intense experience and glad for the support of my team. I was aware that I had crossed a boundary into the taboo territory of death and mutilation; I was transformed rather than disturbed.<\/p>\n
A few weeks into the course, my great-grandmother died.\u00a0 Her name was Anna and she was the first relative to die in my family since I was six.\u00a0 Grandma Anna was my mother\u2019s mother\u2019s mother, and she was the last of the immigrant generation of my family.\u00a0 She was born in Lithuania and had come to America in 1900.\u00a0 She was 105 when she died, and she had remained lucid throughout her long life.\u00a0 She lived in the Chicago area along with my great aunt, so the funeral was held locally.\u00a0 I was able to attend the funeral without traveling, and therefore, only missed one day of school:\u00a0 the day of the funeral itself.\u00a0 This was the first funeral I had ever attended, and it was an open-casket service. I had known Grandma Anna throughout my life and had visited her at least every other year.\u00a0 She had always been very old in my memory-she was in her 80\u2019s when I was born\u2014and I had had few meaningful conversations with her, maybe none.\u00a0 But my mother grew up with her as a member of the household, and I had come to know her through the stories my mother told.<\/p>\n
As the service began, I sat with my family in the front row.\u00a0 This was the first time I had seen the casket, any casket, and I couldn\u2019t look away.\u00a0 From where I sat, I couldn\u2019t quite see into the casket far enough to see Anna.\u00a0 I could just see part of her pink suit\u2014I recognized the suit from one of her recent birthday parties.\u00a0 Once she hit 100, the family made a point of having a birthday party with everyone there each year.\u00a0 Sitting at the service, I remembered saying goodbye to her each year as if that would be the last time.\u00a0 I remembered her thick Yiddish accent and how she was embarrassed of her snarled teeth, so she would try not to smile with her mouth even as she smiled with her eyes.\u00a0 I remembered her hands.\u00a0 She had been a seamstress and hat-maker.\u00a0 She\u2019d made all of my mother\u2019s childhood clothes.\u00a0 I had a pile of dolls\u2019 clothes that Anna had made from the scraps of material used for the family\u2019s clothes.\u00a0 I wondered what her hands looked like in the casket, but I couldn\u2019t quite see.<\/p>\n
As the service ended, our front row of family filed past the casket first. I looked at Grandma Anna\u2019s closed eyes and uncharacteristically peaceful expression. <\/em><\/p>\nHer face is the wrong color<\/em>.<\/p>\nFleetingly disoriented, I scanned the rest of her form. Her hands were folded across her stomach quietly.\u00a0 That was wrong, too.\u00a0 Her hands were always busy\u2014plucking at lint, rearranging a knick-knack, offering a candy.\u00a0 I knew that her hands couldn\u2019t move any more, but their stillness disturbed me.<\/p>\n
I wonder what our cadaver looked like alive. How he moved.<\/em><\/p>\nI watched my mother and grandmother cry, and I felt so sad for them.\u00a0 But no tears came for me.<\/p>\n
When I returned to Anatomy lab the next afternoon, I was glad to be back with my friends and ready to catch up on what I\u2019d missed the day before.\u00a0 We were working on the front side of our cadaver that day, and his face was uncovered.\u00a0 As I got to work on the next dissection, I found my thoughts drifting relentlessly back to Grandma Anna\u2019s face in the casket the day before.\u00a0 I felt my heart rate speed up and my breathing get shallower.\u00a0 My hands started shaking just a little.\u00a0 I couldn\u2019t keep from seeing Anna\u2019s face on our cadaver as I worked.<\/p>\n
Just hold on and keep going\u2014this is only a reaction to the funeral.<\/em> Keep it together.\u00a0 You can\u2019t miss any more lab time<\/em>. Keep going.<\/em><\/p>\nI then realized I was no longer moving, I was just standing there and staring at the cadaver\u2014frozen.\u00a0 My team stood there looking at me questioningly.<\/p>\n
I have to make this stop. I have to get out of here<\/em>.<\/p>\nI put down my instruments and told them I needed some air.\u00a0 I walked out of the lab building to the courtyard outside, my head filled with images of Anna and the cadaver, all blended together.\u00a0 I was crying and shaking and pacing around near the door of the building in my stinky anatomy scrubs.\u00a0 I wanted to run away. I wanted to go back in.\u00a0 I was furious with myself for having this melt-down now.<\/p>\n
Why couldn\u2019t I cry at the funeral like a normal person?<\/em> This is humiliating and interfering with my education.\u00a0 Get a grip, Jennifer.\u00a0 You\u2019re wasting time out here<\/em>.<\/p>\nAs I berated myself in the chilly stone courtyard, my anatomy team showed up, all three of them, in their stinky scrubs.\u00a0 They simply came to me and put their arms around me.\u00a0 Someone said, \u201cYour grandma?\u201d And I nodded.\u00a0 We huddled there silently together, my team\u2019s support and understanding warmed me as much as their bodies did.\u00a0 After a minute or so, I realized that I was keeping us all from our work in the lab.\u00a0 I took a deep breath, broke free of the group, and said, \u201cLet\u2019s go back inside.\u00a0 I\u2019m better now.\u201d\u00a0 Following my smelly teammates back inside, I squeezed the choking sadness from my throat down into my chest, willing it to stay out of my way.\u00a0 I didn\u2019t have any more time for crying\u2014I had anatomy lab.\u00a0 That invisible act of will was Disconnection 101, the first of many lessons in how to detach from my emotions in order to function as a physician.<\/p>\n
First Patient Interview<\/strong><\/p>\nAnother of our first-year courses was called Introduction to Clinical Medicine.\u00a0 In contrast to the ancient tradition of gross anatomy in medical training, this class was quite progressive for its time.\u00a0 Rather than waiting until the third year, our medical school integrated clinical training from the start of the first year.\u00a0 We were taught how to take a medical history and conduct a patient interview in a professional, medical manner.\u00a0 One of our early assignments was to go into the hospital and interview an inpatient (who had agreed ahead of time to participate).\u00a0 I was in my third week of medical school on the day of my first patient interview.<\/p>\n
Since the majority of our classes were not held in the medical center, I had not yet been to the inpatient wards of the hospital.\u00a0 I set out from the medical student lounge, which was located in the basement of the building adjacent to the hospital (our lounge was right next to the morgue\u2014to give a sense of our relative position in the medical universe).\u00a0 On that day, I had worn a skirt and blouse rather than my customary jeans and sweatshirt. Before I headed toward the hospital, I pulled my white coat out of my locker, where it had hung since the White Coat Ceremony a few weeks earlier. I nervously put it on and looked at the young doctor in the mirror.<\/p>\n
Wow, I look a lot more confident than I feel<\/em>.<\/p>\nAs I walked down the long corridor toward the hospital, I passed the dozens of framed medical school class portraits that lined the walls.\u00a0 I looked at hundreds of faces of past graduates\u2014now all physicians.\u00a0 They all looked so competent and smart and\u2026 solid.\u00a0 It was hard to imagine any of them feeling as unsure and lost and scared as I did at that moment.<\/p>\n
My picture will be on this wall in four years.\u00a0 How?<\/em><\/p>\nI kept walking at a brisk pace with my head up and my face composed.\u00a0 I carried \u2013 or rather, clutched with a death-grip — the leather folder I\u2019d just been given as a college graduation present.<\/p>\n
Who gave this folder to me?<\/em><\/p>\nInside the folder, which my sweaty hand was probably staining, were the notes with my patient history questions.<\/p>\n
As I neared the hospital building, I began to pass more medical people and fewer administrative people.\u00a0 I saw an increasing number of physicians walking past in their white coats.\u00a0 I kept glancing down at myself, wondering if my hospital ID was properly displayed and whether my white coat looked right.<\/p>\n
Buttoned or unbuttoned? <\/em><\/p>\nI reached over to button my open coat.<\/p>\n
No! Don\u2019t fuss with the coat now\u2014you\u2019ll look even more clueless. <\/em><\/p>\nMy hand dropped back to my side.\u00a0 I kept walking, staring straight ahead, heart pounding.<\/p>\n
Oh God, they\u2019re all looking at me and they all know I have no idea where I\u2019m going or what I\u2019m doing. <\/em><\/p>\nThe paranoia took hold. <\/em>I expected one of the hospital staff to stop me and question my presence there.\u00a0 It was only moments before someone would figure out I was an imposter\u2014disguised in a white coat.<\/p>\nAs I approached the nurse\u2019s station near my patient\u2019s room, I saw a handful of nurses and doctors sitting and standing around the counter.\u00a0 I needed to check the \u201cwhite board\u201d at the nurses\u2019 station to confirm the room number.\u00a0 A couple of people glanced at me as I arrived at the counter to look at the board.\u00a0 One of the nurses who sat behind the counter seemed annoyed to see me, but she seemed annoyed by everyone else, too.<\/p>\n
OK\u2014I\u2019ll keep away from that one.<\/em><\/p>\nMostly, they all ignored me and went about their work of making notes in patient charts and talking on the phones.\u00a0 The group exuded a general air of weariness, but a few of the faces were cheerful and I could make out at least one friendly conversation.\u00a0 I tried to figure out which person was going to blow the whistle on me as the unqualified interloper.\u00a0 I nodded and smiled at a few residents in scrubs and white coats, got a look at the white board, and headed off toward my patient\u2019s room.<\/p>\n
Nice job, Dr. Hasenyager\u2026you kept cool, blended in. That was pretty slick. <\/em><\/p>\nMy tiny self-satisfied smile evaporated when I realized I had set out in the wrong direction and would need to double back in order to get to my patient\u2019s room.<\/p>\n
Shit<\/em>.<\/p>\nI started losing my composure, tearing up slightly as I did a U-turn in the hallway and walked as fast as I could past the nurses\u2019 station\u2014my eyes fixed straight ahead and my leather folder held defensively across my chest.\u00a0 Those last few seconds before arriving at my patient\u2019s room expanded as fear warped my sense of time.<\/p>\n
I don\u2019t think I can pull this off–of course I can pull this off. What if she (the patient) is mean? What if she won\u2019t talk to me? How do I introduce myself? Dr. Hasenyager?\u00a0 Jennifer?\u00a0 Dr. Jennifer?\u00a0 Student Doctor Hasenyager?\u00a0 What if someone asks me a question\u2026a MEDICAL question? Oh my God, I have no idea what I\u2019m doing. <\/em><\/p>\nI watched my hand knock on the cheap hospital room door.<\/p>\n
Just play the part and hope for the best<\/em>.<\/p>\nI walked in, smiled, took a deep breath, and started acting.\u00a0 I don\u2019t remember a lot about our interview.\u00a0 I know that I asked the questions I was supposed to ask and that I managed to take notes while simultaneously maintaining the impression I was a confident professional.\u00a0 I remember my patient was a very sweet and chatty woman in her 70\u2019s and that her husband was also in the room.\u00a0 They both seemed to believe I was a doctor and I knew what I was doing.\u00a0 My patient was scared about loosing her independence at home and didn\u2019t know if her husband could manage to take care of her.\u00a0 She didn\u2019t come out and say those things to me, but I could tell from the way she answered my questions.\u00a0 Her husband had no idea she was worried. I was completely unaware that my knack for picking up unspoken information was both a gift and vulnerability.\u00a0 Ignoring my instincts, I focused on the data\u2014the black and white answers to the questions on my list.\u00a0 I spent about thirty minutes talking to them, firmly shook their hands goodbye, and escaped back into the hallway.<\/p>\n
As I walked back toward the student lounge, I reflected on my performance. No one seemed to notice how clueless and scared I was.\u00a0 As long as I played the part and concealed myself, I was passing as a doctor.<\/p>\n
I can fool them all with this white coat on–amazing<\/em>.<\/p>\nIn that long hallway, I noticed the doctors swung their clipboards and folders loosely by their sides rather than holding them tightly to their chests as a school girl would hold her books.\u00a0 I looked down at my tightly-held folder and let it swing by my side.<\/p>\n
Hands in Anatomy Lab<\/strong><\/p>\nAs the first year went by, we all settled into the routine of our classes and our new roles as physicians in training.\u00a0 The sharp creases in our new white coats relaxed, and so did we.\u00a0 There were many classes\u2014biochemistry, immunology, histology, physiology\u2014but anatomy remained the symbolic and literal engine of our transformation from college kids to physicians.\u00a0 At about the mid-point of our six-month long gross anatomy course, the time came to dissect our cadaver\u2019s hands.\u00a0 Until that time, his hands had remained wrapped in cloth and plastic baggies.\u00a0 Our instructors had explained to us early on that the tissues of the fingers (and toes) were very thin and delicate and would easily deteriorate if they were exposed to air.\u00a0 We were, therefore, asked to leave the hands and feet wrapped in the preservative-soaked cloths until the time came to do the dissection.<\/p>\n
On the day of the hand dissection, my lab team gathered around our cadaver and paused.\u00a0 I felt nervous, almost reluctant, to unwrap his hands.\u00a0 I think my three teammates did, too.\u00a0 We didn\u2019t talk about being nervous and the pause was brief.\u00a0 Then two of us began to unwrap\u2014one on each side.\u00a0 I clearly remember being one of the unwrappers, though I\u2019m not sure which hand I worked on.\u00a0 As I removed layers of damp cloth, I became increasingly tense.<\/p>\n
I don\u2019t like this.\u00a0 How did I end up doing this job?<\/em><\/p>\nI felt a vague dread as the last layers came off and I held his bare hand in mine.<\/p>\n
His nails were neatly trimmed.\u00a0 His fingers were long and thin.\u00a0 There were the usual age spots one would expect on a 70-year-old person\u2019s hands, but they were otherwise very nice looking hands.\u00a0 I turned his hand back and forth.<\/p>\n
What did he do?<\/em><\/p>\nI saw images of him working at a cheap metal office desk with a goose-neck lamp.<\/p>\n
Accountant at a small company?<\/em><\/p>\nI saw him holding a book in a comfortable chair, reading for pleasure.\u00a0 I saw him holding his wife\u2019s hand as he spent his last few days <\/em>in a hospital.\u00a0 I saw him petting his dog.<\/p>\nHe was kind<\/em>.<\/p>\nEven though I had laid my hands on every one of his internal organs, traced his blood vessels and nerves through his body, and discovered that he\u2019d had a hip replacement, until that moment, I hadn\u2019t felt connected to him as a living human being.\u00a0 Now, I was connected. My breath caught. I wanted to show my gratitude by acknowledging his...personhood.<\/p>\n
Oh, you dear man.\u00a0 Thank you.\u00a0 Thank you for your gift to me. <\/em><\/p>\nHere was a person whose name and life I would never know, yet I knew all about him.\u00a0 I knew things about him that none of his loved ones could ever know, like the way his heart looked on the inside.\u00a0 I knew him. And at that moment I could not bring myself to destroy his hand.\u00a0 I wondered if he was grumpy when he woke up in the morning until he had his coffee, or if he was an early riser who relished the quiet of the dawn.\u00a0 I wondered if he\u2019d had a good life, filled with love and satisfaction\u2014I hoped so.\u00a0 I wondered why he\u2019d chosen to donate his body for our education.\u00a0 Despite knowing that it was his wish to give his body in this way, I still held his hand, unwilling to deconstruct it.<\/p>\n
All of those thoughts and feelings must have flashed by quickly because none of my team members seemed aware I was hesitating to begin the dissection.\u00a0 They were busy reviewing the lab manual and arranging instruments.\u00a0 His other hand had also been unwrapped.<\/p>\n
How can I do this to him? <\/em><\/p>\nI felt deep regret as I set down his hand and tried to focus on the lesson plan. My teammate read from the manual about where the first incision was to be made.<\/p>\n
There is no way I\u2019m making that incision<\/em>.<\/p>\nThe internal mutiny was gaining momentum, and I tried to reason with myself. <\/em><\/p>\nWhat\u2019s wrong with you?\u00a0 You\u2019ve been doing anatomy for months now.\u00a0 Hands are just another body part.\u00a0 Get a grip. <\/em><\/p>\nTime was running out\u2014the team was going to notice my squeamishness very soon.<\/p>\n
They won\u2019t understand this.\u00a0 Freezing up over a dead grandmother is one thing, but a sudden personal relationship with your cadaver is over the line. <\/em><\/p>\nI was looking down at the lab manual, pretending to study it as I silently scrambled to get control of my powerful aversion.\u00a0 Staring at the hand diagrams on the white page, the images began to blur out, leaving just the whiteness.\u00a0 There was something soothing in that cool, white space.\u00a0 In my desperation to conceal my distress from my teammates, I concentrated intently on the white, and it began to seem that I was entering that white space, becoming surrounded by it.\u00a0 The calming whiteness contained a beautiful silence, as if it insulated me from the paralyzing clamor of my emotional reaction.<\/p>\n
That\u2019s better.\u00a0 Stay here.<\/em><\/p>\nI took on the calm of the white room that had formed around me. I kept my eyes on the lab book rather than on his hands until I was sure that the first few incisions had been made by someone else.\u00a0 When I finally looked up from the book, the white room faded from my vision, but its calming effect lingered.\u00a0 My pain at dissecting his hands wasn\u2019t gone, but it seemed much farther away.\u00a0 I picked up the instruments and did my share of the work.\u00a0 My stomach hurt a little, but my head was clear and my hands were steady.\u00a0 Most importantly, no one knew that I\u2019d struggled at all that day.<\/p>\n","protected":false},"excerpt":{"rendered":"
Tonight I take on the identity of Physician. One hundred and fourteen brand-new medical students milled expectantly, many with their families, in a large university hall that reminded me of a hotel ballroom. Tonight I take on the identity of Physician, the familiar chattering voice in my head was unusually somber that night,\u00a0 Physician.\u00a0 Doctor.\u00a0 […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-1654","post","type-post","status-publish","format-standard","hentry","category-memoirs"],"_links":{"self":[{"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/posts\/1654","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/comments?post=1654"}],"version-history":[{"count":6,"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/posts\/1654\/revisions"}],"predecessor-version":[{"id":1846,"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/posts\/1654\/revisions\/1846"}],"wp:attachment":[{"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/media?parent=1654"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/categories?post=1654"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/ducts.sundresspublications.com\/content\/wp-json\/wp\/v2\/tags?post=1654"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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