Saturday, April 21, 2012

Watching life in reverse

I am back at med school in a week, and that means being back in clinics and hospitals. I'm excited because I finally get to practice one of those few clinical skills that make med students feel like doctors - venepuncture! This hospital stint I have coming up will be different than the others because while I have previously only met older patients because of the diseases we have been looking at, this time the conditions of interest can occur in patients of all ages.  While I hope to meet lots of patients with a range of rare and unusual ailments, at the same time, this might make things a bit difficult for me and things could go downhill very quickly.

For the last two years, I have been getting used to talking to patients who are nearing retirement or who have already passed that stage of their life, and I find it really easy to build a rapport with them and get a history out of them. Most of my problems interacting with others become apparent when I talk to people nearer my own age, and that's just with normal conversation.

Talking to a patient my age about a cancer that could kill them in the next five years adds a new layer of complexity to the encounter; the older patients I have met with cancers and other terminal diseases have all come to terms with it in different ways, but the common theme amongst them was that they were happy with the life they had led. I can't even pretend to know how I would deal with being told I had cancer tomorrow, but I imagine the first thing that would go through my mind is the fact that I haven't even graduated med school yet!  These new patients will be people who should still have at least forty years of life ahead of them... How do I talk about this with them!?

Some of these patients might be even younger than me, still in school or even nursery.  Talking to someone my age about something that might kill them would be bad enough, but talking to a 3-year-old's parents about the same thing is something I don't even want to think about!

I shouldn't worry about this yet anyway; I still have a few weeks before I start my hospital stint, and I might not meet any young patients with fatal diseases at all.  A part of me hopes that is true, but I know that the experience would only be a good one that will benefit me later as a doctor.

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