Despite exhausting the hypothetical pros and cons of pursuing a medical career well before applying to med school, it was after I started university that I truly began to realise what being a doctor is really about.
Sunday mornings during 1st year tend to be the quietest and calmest part of the week. Most people are recovering from the weekend parties or attempting to hastily complete assignments left till the last minute. At 10am one Sunday morning, a panicky succession of knocks woke me up. I was met with the concerned face of my flatmate’s sister, Becky, who was visiting for the weekend. “Alice hurt her ankle, and she’s in a lot of pain, and I don’t know what to do. You’re a doctor what should we do?” This was the first time someone had come to me relying on my vastly inexperienced medical opinion, let alone incorrectly addressed me as a doctor. My mind went momentarily blank, and all it could conjure were the entirely irrelevant names of several enzymes involved in the inflammatory cascade (we had just learnt these in lectures). Initially a little flustered, I followed her to find my injured flatmate, Alice, sitting on a chair tightly clasping the arms. She was clearly in a lot of pain. I smiled at her and asked to look at her ankle, to which she nodded. It was slightly swollen and a little red. “How did it happen?” I asked. “We went trampolining and I landed funnily on my ankle. We left and got a taxi back straight away,” she winced in reply.
Feet consist of many little bones (known as tarsals, metatarsals and phalanges), all held together by cartilaginous ligaments. The ankle acts as a hinge to allow you to flex and extend your foot, along with a small amount of inversion and eversion. The ankle is also surrounded by ligaments that hold everything together to maintain balance of the relatively large body mass it is required to support. Because of this function, the ankle joint sacrifices some range of movement in exchange for better stability. For this reason, any sudden changes in movement or awkward landings, likely to occur during trampolining for example, may strain these ankle ligaments.
Of course, none of these thoughts were in my mind in the moment; I was instead baffled by the fact there was no first-aid administered at the trampolining venue. What did occur to me were the 5 cardinal symptoms of inflammation: pain, redness, swelling, heat and loss of function. Alice had all 5 on her ankle, and so I could be sure that we were dealing with inflammation. However, there was not very much redness, only a little swelling, and she could move her foot in all directions, albeit to a lesser extent than normal and with some pain. This was reassuring, as it was more likely a ligament sprain than a serious fracture.
RICE – Rest Ice Compress Elevate. A simple mnemonic I remembered learning during a first aid session, back when I did DofE during school. Becky immediately understood when I mentioned RICE and went straight to the freezer to find something icy cold. In the meantime, I lay my flatmate down, placing some pillows under her injured foot. We then wrapped a towel around a bag of peas around the ankle, whilst applying some pressure. Within an hour, Alice was walking around the flat much more comfortably.
This was by no means a dramatic or difficult medical situation, however I was thanked plenty. I found this confusing as I had essentially done very little. I’d walked over, confirmed the injury to myself and decided it didn’t look “that bad”, contextualised the injury to what I’d been taught in lectures that had no real effect on managing the situation, and then implemented measures that most lay-people have been taught at some point. Alice explained she felt reassured that I seemed to know what I was doing and appreciated that I smiled, making her feel much calmer. It wasn’t necessarily what I did that they appreciated most, it was how I did it. During my clinical experiences so far in medical school, I’ve learnt that this is one of the most important components of being an effective and appreciated doctor.
I remember the lessons from this event very clearly, because it demonstrates the basis of a successful clinician-patient relationship. The intricate sciences of medicine are fundamental to effective practice. But it is the manner in which the science is applied to the unique anatomy, physiology and psychology of each person, that separates doctors from scientists. If you stop for 2 seconds and try to understand what the patient is going through, it establishes a foundation of trust and makes that patient’s care much more effective.
If you are thinking about applying to medical school, I would encourage you to do so. Medicine is a fantastic subject that combines so many aspects of science, psychology, sociology and more. Every encounter with patients provides valuable medical lessons, but also life lessons.
Within my first month in Southampton medical school, I was assigned a couple who had agreed to let me keep them company and observe the birth of their baby daughter. I was then invited to their home months later, where I observed a follow-up appointment with a community midwife and learnt through real experience some of the important milestones for babies’ growth. Since then I have been thrown into countless valuable experiences. To name a few: I’ve taken GP clinic appointments; assisted in various surgery theatres whilst wearing a visor splattered with blood and bone; intubated a child (taking over a patient’s respiratory function prior to surgery); published a research paper and presented it at a conference in Chicago; discussed the hallucinations and delusions of deeply disturbed patients; visited a prison where I saw the reality of long-term unaddressed mental illness and gave a crying mother some tissues whilst her son was being resuscitated.
Medicine opens a plethora of options after you graduate. I know doctors who have gone into scientific research, business, finance, management, medical law, politics; the list is lengthy. And the fact is, each of the several specialties within medicine itself offers something completely different to the next, offering various work-life balances and an extensive spectrum of opportunities.
Yes, medical school is hard work, but so is any worthy profession you may pursue. It is a long career, but as a doctor each decision can have a profound impact on multiple lives. It is therefore vital that every doctor has an extensive library of experiences and knowledge before having to make such critical decisions. Each year of training cumulatively builds in responsibility and expectations; several years before being a fully qualified consultant, doctors may be responsible for patient-care on entire wards. My first experience of helping someone with a sprained ankle affects how I interact with patients to this date, as do all the experiences I’ve had since.
Why Medicine? Simply put, it is a career that involves truly making a difference. Making an absolute difference to people’s lives, and the lives of those surrounding them. There is so much more to say, but crucially I am excited for my future career and start each day looking forward to what I’ll see, experience and learn next.