The transition from the first to second year of medical school is fairly seamless as far as our daily routine is structured. In both years we’re mostly in the classroom, pouring through thousands of pages of medical facts and diagrams, learning PowerPoint slide bullet points and preparing to one day use this information to treat actual patients. Of course, the difference between our first and second years consists of more than that. We’re a year more practiced at seeing patients under the guidance of our preceptors and other physicians, we have most of the normal human physiology under our belts and by now, much of the pathology too. In essence, I can understand many medical conversations, though I’m still not great at participating in them.
There is another notable difference between first and second year that really came to life over Thanksgiving break, and that is how family and friends viewed me a year and a half ago compared to now. As a first year medical student, people are focused on the fact that you earned acceptance into medical school and are ‘on the road to becoming a doctor.’ Earning a spot on this ‘road’ is an accomplishment in itself, and therefore during your first year, you get a lot of congratulations, pats on the back, and maybe even a special toast during Thanksgiving dinner. As a second year, however, all that is behind you. Your acceptance into medical school is a distant memory, and now you are instead expected to be an expert in all things medical and health care related.
It turns out that being a part of the medical community has a unique effect on some individuals, and I don’t mean on patients, I mean on everyday people. This year, when I showed up to Thanksgiving, I quickly realized I was no longer just a member of the family. Instead, I am a walking, talking representative of United States health care, the Obamacare debate, current research in cancer and other medical topics, and the best person to ask if your shoulder hurts, if your left foot gets sore after you run, or if you feel a burning sensation when you pee. Perhaps this is something to get used to overtime, but as a new experience, it’s hard to know how to manage.
My uncle sells industrial-sized farming equipment for a living. When we get together, I don’t grill him on the legitimacy of our country’s agriculture system. My grandmother is a judge, but I rarely ask her about the latest Supreme Court case. Health care, however, seems to be what everyone wants to talk about.
When I sat down for a pizza dinner with 15 members of my extended family the night before Thanksgiving, I was excited to see everyone, anticipating four full days of relaxation. Before I could bite into my first piece of cheesy bread, however, one uncle asked, ‘David, do you think you’ll be able to support yourself given the low wages doctors will earn with Obamacare?” Well now, I was not expecting to have to think about this on this night of all nights! As I tried to brush off my uncle’s question with a joke, before I knew it, my other uncle had his finger in my face, arguing against the merits of government-controlled health care as if I am the one entrusted with making the final decision for the American people. This went on until thankfully my grandmother, from the corner of the table, demanded that we change the subject.
The next morning, as I was sipping a glass of orange juice, my cousin asked me about cancer research, ‘Why haven’t we cured cancer yet, given all the money we spend on it?’ I looked down at my glass, incredulous considering I had woken up a mere five minutes prior. ‘Wow, how much time do you have?’ I asked, probably a bit too condescendingly. This sparked a conversation about cancer, which led into old age and life expectancy, and eventually spiraled out of control when it was suggested we should be living to be 200 years old given all we know about nutrition.
If you’re a doctor and have been one for years, you’re probably used to this somewhat absurd banter. You’ve probably found a way to dodge these types of questions and change the subject, or perhaps you enjoy discussing medicine one hundred percent of the time. Personally, I am interested in lots of things, including medicine, but also including spending normal time with my family and not thinking about the subject I spend ninety-nine percent of my time doing. This weekend got me thinking about all of this, and I came to a few brief conclusions.
First, I am lucky to be in medical school. There are few topics more interesting and that have such a large effect on nearly everyone. No matter who we are, we all know someone who is sick and also know that at any time, each one of us can fall victim to our own health. Second, the more I learn as part of this field, the more difficult it may be to deal with common misconceptions, such as the fact that cancer (which in reality is not one disease, but many) can simply be cured with a single magical solution. I think it will be up to me, as well as other new members of the medical field, to understand that people who work in different industries will indeed ask me these types of questions. I need to find good answers that make sense to people outside of the field, which is a similar process to explaining a disease process to a patient who has no previous knowledge of the particular topic.
Finally, and perhaps the most difficult lesson to swallow from all of this, is that there is still so, so much that I do not know. Despite the thousands of hours of studying and stress, I am still very new in this field, and when you consider the range of questions one can ask about medicine and health care, I actually still know very little. Which reminds me, now that break is over, I should get back to studying.