When people ask me, “How’s medical school?” many experiences are on my mind, but discretion leads me to answer, “It’s good! I’m really happy.” But when I ask myself this question, I try to answer it more bluntly. Though most of the time I really enjoy it, sometimes school is exhausting.
I never know how much detail to give to friends and family outside of school. Much of the time what I share are fascinating crowd-pleasers, but some things on my mind, far from geeky science factoids, are trickier to bring up at a birthday party.
The truth is that while learning the practice of medicine is exhilarating, some days are a lot less exciting and a lot harder to bear. Behind almost every operation, technique, and discovery in medicine is human suffering, and we are reminded of that every day. On some days, the message is loud and clear.
For example, a Monday schedule just two weeks ago went like this:
9:30 AM: Lecture 17, The Brainstem Nuclei
10:30 AM: Lecture 18, Cerebral Cortex
11:30 AM: Required Patient Session, Chronic Granulomatous Disease
12:30 PM: [OPTIONAL]: Intimate Partner Violence Didactic
1:30 PM Health Policy (Cost, Cost Effectiveness Analysis, and Policy)
3:30 PM: Clinical Skills (Intimate Partner Violence)
My schedule looked almost like any other Monday, but the content was emotionally harder than most. Walking out of my Clinical Skills session in the evening, I looked down at my white coat hanging over my arm. It looked as clumsy and limp as I felt inside. I placed the back of my hand against my face and felt anger radiating from my reddening cheeks while the events of that day playing back in my head.
That morning, after two hours of lectures on the nervous system, we had a patient visit during our lecture on immunology. This patient recounted his experiences of being ignored by doctors who don’t understand what it’s like to live life like “the Bubble Boy.” Next, with rumbling and hungry bellies, we sat through our optional lecture at lunchtime, an extra session to prepare us for our afternoon of interviewing patient actors.
In our class on cost effectiveness, we brainstormed ways to manage the financial and ethical burdens of new therapies. We discussed one medication that allows patients born with severely grave spinal muscular atrophy at infancy to live indefinitely through a human lifespan. Though an amazing discovery, there is the caveat that the medication costs almost a million dollars in the first year of treatment and almost $450K per year thereafter (imagine 65+ years). These days, discussions of health care seem to end with the question: Where should that money come from? As in most health policy sessions, we had a debate, we couldn’t come up with definitively better solutions, and I left feeling disheartened.
To finish the day, we practiced interviewing patients who have experienced intimate partner violence. I listened to a woman gingerly describe her passion for gardening until the conversation turned to her husband’s abuse over their 23 years of marriage. I listened to a man describe how his wife pushed him, breaking his wrist. I knew these were actors helping us learn through practice, but I also knew that many of my future patients are currently experiencing intimate partner violence. I felt helpless, and I mulled over this until a few days later when the next slew of stimulating classes, ethics and operative anatomy, distracted me. Another turn of the wheel.
On that same Monday described above, I texted with a friend and gave her the real answer to “How’s medical school going?”:
Today was a really tough day… Instead of feeling motivated I’m angry, and sad, and helpless all at the same time. But, I keep plugging away because I trust in the process… I sometimes feel way in over my head. What fuels me is knowing how many people I know and love, and who make me feel loved… I’m reminded that people believe in me, and then I believe in myself, and it gets better.
Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category.
Lauren Joseph, LoJo, is a first-year medical student from Arcadia, California. She graduated from Stanford in 2017 and spent one year working in San Francisco before starting medical school. She is thrilled to be back at Stanford. She loves cooking, reading, running, and laughing with friends and family.
Photo by Rod Searcey