medicine · MS-4 · narrative medicine · New York

Not done yet

I had brunch with a good friend today, down in the West Village.  She is a literature PhD candidate, about to switch careers and head down the med school route.  And I was telling her about my own near-career switch, back when I was a fourth-year undergraduate so in love with my comp lit thesis that I was about to withdraw all my applications to medical school and apply to lit Ph.D. programs instead.

“But I’m glad I didn’t,” said I between forkfuls of an exceedingly delicious Greek salad with herbed goat cheese. (You can order things like this in the West Village — such a change from the chicken-and-rice cart outside the hospital.) “Because then narrative medicine turned up, and I got to do that instead. I needed that year, but I missed clinical medicine so much.”

“And it sounds like, from what you said about your thesis, that you weren’t done with literature yet, you still wanted to explore.”

“Yeah. And there’s a lot more still to explore — I feel like I just learned a lot of new vocabulary and am barely getting past the surface. Maybe I’ll go back, do a PhD later. But for now… I really need to take care of people.”

I think I’d never articulated that to myself before. Back in November, I started really missing medicine in a very visceral way. I missed the process of history-taking, the back-and-forth, the reconstructed (co-constructed?) timeline of events. I missed the thrill of physical exam findings. (The differentiation between aortic stenosis and hypertrophic obstructive cardiomyopathy is hot.) I missed curbsiding my friends on other services to ask their opinion about xyz, or frantically UpToDating at the nurses’ station. I missed the putting-it-all-together, the generation of a coherent story to pass along to my resident and attending.  As soon as I could rearrange my schedule appropriately, I began volunteering at the free clinic, in order to get at least a little of that back.

There was a re-learning curve at the beginning of this month — I had to look up how to write notes, I had to look up the most basic principles of pathophys, I even once had to look up the normal values for coagulation factors. *shame* But now that I’m back in the swing of things, I feel too excited by it ever to want to leave again. I mean, I helped convince a man to make a lifestyle change that has already dropped his weight by 110 pounds. One hundred and freaking ten pounds — that’s a me. Formerly inside him; like Athena and Zeus. The man now feels better, breathes easier, walks longer. How can you not be excited by that?

So, no, I’m not “done yet” with literature.  But more importantly, I’m not done yet with medicine. As frustrating as the hospital can be at times — one of my patients has been hanging out for a week because of discharge planning problems — it’s also hugely fulfilling. Not necessarily just in the “good outcomes” way, but also in the sheer pleasure of doing something that is of use to other people.

Our conversation moved on to other things, like the evils of the application process (med school vs. residency), the commercialism of Times Square, the sheer awesomeness of Zadie Smith. But that “not done yet” line of K’s lingered in my brain.

Who knew that such profound moments could arise in a slightly hipster joint off Christopher Street?

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