The dilemma of being a medical student on clinical rounds who wants to help patients but can’t was captured by third-year student Raymond Deng in his essay “Performing Grief,” at a recent reading held by Stanford’s Medicine and the Muse Program and Pegasus Physician Writers group.
The event, titled “Becoming a Real Doctor: Writings on Medical Education and Training,” also featured a poetry reading by fourth-year medical student Lauren Pischel, a book excerpt by Cornell physician Matt McCarthy, MD, and essay readings by Emily Liu, a second-year medical student, and Louise Wen, MD.
The audience of medical students, physicians, residents, nurses and community members listened attentively as Deng described what it can feel like to be a medical student:
For a year or two, you will inch your way on the tightrope towards white-coated authority from diligently reproduced sham. What you lack in clinical knowledge, you will compensate for with the appropriate attire. Be meticulous. Put on your requisite, freshly-pressed white coat. Hang your stethoscope across the nape of your neck. Cram the pockets of your white coat so full of notes and reference guides that they sag. Ignore the nagging incongruence: the fact that you're not a doctor but you look like one. You want to help patients, but will settle for watching... You will feel like a cardboard marionette, dancing to the steady rhythm of acting competent and acting ignorant of your acting.
For Wen, it was acting against the rules of eating in the area of clinical care that afforded her the opportunity to connect with her patient, Sara, on a personal level:
“Hey doc, here’s a treat for you, I know you guys work hard… Here, try some Afghani bread.” She looks up, eager to connect, and my own yearning to know this women beyond her illness swells within my chest. I can recite numerous details and data points about her medical history and hospital course, but her life as a human being is a gaping void.”
Eating the homemade bread, with “the inside as soft as pillowy sponge cake,” led to a sharing of photographs of Afghanistan and a filling of the void for Wen.
The evening was opened by Matt Bucknor, MD, a Stanford alumnus, member of Pegasus Physician Writers and a UCSF radiologist. Bucknor introduced McCarthy, who read from his memoir The Real Doctor Will See You Shortly: A Physician’s First Year. McCarthy’s excerpt described performing chest compressions on a 95-year-old woman with metastatic lung cancer, with McCarthy wondering whether he is doing more harm than good when he hears the patients’ “ribs crack as easily as uncooked spaghetti.” Following the attending’s orders, McCarthy performs the compressions to “Staying Alive,” a song whose beat ionically matches the necessary 100 beats per minute for compression.
McCarthy noted that the opportunity for medical students to write with residents and physicians is unique. “I really don’t know of any other medical school where this happens,” he said. “This is a very special thing happening at Stanford.”