This old white coat

June 17, 2008 at 10:19 pm (Uncategorized)

I’m sitting here at my desk looking at my old white coat. I’ve worn this jacket almost every day over the past year. It’s a reminder of the power and trust that physicians instantly hold with all patients. It’s the universal symbol of healing and knowledge. And yet when it comes right down to it, it is barely more than a glorified bed sheet with buttons and pockets.

It is covered with stains from various bodily fluids, food from the cafeteria, and a mysterious orange color that I have yet to identify. Although I’ve washed it regularly it will continue to be synonymous in my mind transference of infections from one patient to another.

This past year will certainly be memorable to me for a very long time. People talk about medicine as if it’s a calling. At no point have I ever felt as if God or any other deity was telling me to become a physician. But I do know that this is the field for me. Nothing else gets me up in the morning so early and so eager as medicine does.

Unfortunately, not everyone feels the same. So many of my classmates have gotten this far only to realize that they have made a very expensive mistake. I know of at least two people who now openly admit that they dislike medicine. Unfortunately, they are now more than $150,000 in debt and cannot leave the profession. They are now stuck in this job field for no other reason than economics. I think that many physicians are similarly trapped because so few other specialties have a high enough payout to clear the necessary debt that comes with this education. So to all of my pre-med readers out there: know what you’re getting into. This is an 80 hour a week job that comes with high emotional strain, abuse from attendings, abuse from patients, threats of litigation, inability to predict whether or not you will be paid, and a constant worry that maybe you didn’t make the right decision with that last patient. But if you like science, are good with people, and enjoy solving puzzles, then maybe you should consider a career in medicine.

Now that third year is over, I’m amazed by the amount of material that I have learned. I wonder why college took so long. If I were to employ the same model of education to my undergraduate degree that I have to med school, I would have earned my bachelors in about nine months. Despite all I have learned, I feel woefully unprepared to start practicing on my own. I started medical school with the realization that there was a gap in knowledge that needed to be filled before I could become a physician. With each rotation I see that there is no knowledge gap. It is a never ending abyss from which I don’t know if I can ever truly master. I have more training than a physician’s assistant, yet the medical community rightfully recognizes that I should not treat patients on my own. And despite similar realizations from physicians at all levels of training, the government and lobbying organizations continue to push for such asinine developments as “doctor of nurse practitioner.”

I look at this old white coat and realize that I have closed the chapter of one of the hardest years of my life. I look at it with a smile knowing that I don’t have to take a shelf exam ever again. I look at it with a frown knowing that one day my signature will be on the prescription pad or the order form—and that I’ll be the one who’s held accountable. I look at it and wonder where the last year has gone.

Prior to third year I used to exercise for a minimum of one hour a day. I was in such good shape that I had a resting heart rate of just over 50 beats per minute. The Air Force even recognized my athletic abilities when I was at officer training. And now, all that has gone away. When I was studying for STEP I, I gave up exercising so that I can free up more time to prepare for the exam. And then I continued not to work out. Due to the time constraints of this past year, I never got a chance to get back into shape. I also took the easy way out with regard to eating and began choosing fast food and microwavable meals over home cooking.

I tried running this week for the first time in almost 14 months. Once I hit the road I knew in less than 20 minutes at the past year has not been good to me. I gained 10 pounds since the start of third year—which is remarkable given that I’ve weighed the same for the previous decade. I started using a new notch on my belt, my blood pressure has risen by almost 20 points, my resting heart rate is up by 30 beats per minute, and there’s no telling where my cholesterol has gone.

I look at this old white coat knowing that I’m going to have to throw it away. It has simply become too filthy with all of the stains I’ve picked up here to continue its usefulness. And yet I hesitate to throw it away. I feel like there should be some kind of ceremony. A funeral. Simply tossing it into the garbage would be akin to shooting a member of the family in the backyard who has outlived his usefulness. And so there it continues to hang by the door where it has greeted me every morning over the previous year.

I look at this old white coat knowing that my training is almost finished. I look at this old white coat and know that I am about to embark upon the next journey—whether it be as a flight surgeon or in some other specialty. And whether medicine is a calling or simply an interesting job, I look at this old white coat knowing that one day soon I’m going to be a doctor.

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12 Comments

  1. Miami_med said,

    touche

  2. jeek said,

    so, will it be called 3/4 md now?

    good job getting this far :)

  3. aimee said,

    Awesome post!!!! I am with you about the deconditioning….though my heart rate was at 50 (and still is) more because of a congenital heart block than due to my elite athleticism……..

  4. bill said,

    that was a nice read, seriously though, change the name to 3/4 md : )

  5. halfmd said,

    But if I change my name every year, things will get really confusing if readers have to type in PGY-1MD.com

  6. Fidel, MDd said,

    I took (one of) my short coats and sealed it in a vac-bag. For the memories.

    I had a huge fing bonfire with the other one…..Thank God those days are GONE!

  7. Dragonfly said,

    I hated wearing my white coat personally….was so glad to get rid of it.

  8. Tea N. Crumpet said,

    I just wanted to let you know that the finest doctors that I have ever had are former military doctors, Half! They started retiring 3 years ago and are older– I don’t know if they did your program, but I loved them, and they would tell me funny stories about their career.

    I can’t wait to see what you wind up doing– when will you know?

  9. Maureen said,

    Hello! I am a second year medical student at the University of Virginia. I am doing a research project this summer on blogs maintained by medical students and physicians and I have really enjoyed reading yours! I wanted to let you know about an online journal at UVA called Hospital Drive, which can be found at http://hospitaldrive.med.virginia.edu/. I think you and your readers would really enjoy reading and perhaps even submitting material to the journal. Happy Reading!

  10. Brandon Wood said,

    Hooray for Half MD! You won the Scrubby Award for this week on Redscrubs.com. This was really a great read!

    Please email me so we can get your free scrubs in the mail to you.

    Brandon

  11. Jaded said,

    Dear Half,
    I must say that for all your lofty words here, I can see that you have flip-flopped like every medical student before you. As a 3/4 MD myself, I realize that if the up and coming resident could just keep in mind what it felt like to be spoken to by an asshole know-it-all surgeon, maybe they would be decent human beings. I can see that despite my previous hopes that the new generations would learn and seek to change things, change will never come. My friend, you have become a self glorifed asshole.
    Your articles speaking about fake doctors just come to show us what a jerk you are. I’ve got news for you, individuals in those specialties passed the same rotations and suffered the same early mornings and mistreatment that you did. Have a little respect for you colleages and keep in my mind that, despite your beliefs, you are not near as important or smart as you think you are. To quote a great book, “we are all part of the same compost heap.”

    Jaded

  12. NP said,

    Congratulations on all of your accomplishments. I do just have to throw in that a DNP (doctorate of nursing practice) isn’t asinine. Simply one of two terminal degrees in the nursing field – the other being a phd. You wouldn’t call a phd asinine, I’m sure.

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