A Poem: Beginnings and Endings

Nervous. Excited. Elated. Terrified.

Sitting amongst my fellow future doctors
The new physicians in training.
I’m going to be a doctor -
I’m just a medical student, next to nothing
Received my first white coat: shiny, clean
Wondering how long that will last…
Feeling part of the tradition
Knowing my parents are so proud -
So began my first week of medical school.

Slicing into skin, thinking the person was dead
Only to watch red blood ooze from the incision, drip down the sides
And onto a forming puddle on the floor;
The skin was so cold, so blue.
I watch as the fly meanders, buzzing through the abdominal cavity,
Settling on a succulent intestine, pink
I’m looking at this living carcass,
And suddenly an artery bursts,
And I wake up with a buzz in my ears.
Body 3878: I remember where I was when I first saw her face,
But her face? I forget. I have to.
The nightmares don’t end -
I don’t know what’s real and what’s a dream.

Talking to patients, practicing taking histories,
I know I am wasting their time.
I’m not a doctor, I’m not really anything
Just trying to learn the skills, the techniques
Hoping that someday I’ll be able to talk like one.
Fumbling with the blood pressure cuff,
Peering at the retina, pretending to see something I don’t.
I’m acting as a doctor
Hoping that someday the acting will feel real.

Rotating through the wards of the hospital:
Trying so hard to be the part of the doctor,
Reprimanded by my teachers -
Like the student, the child that I am.
Running to the bathroom to cry my tears
Feeling I’ve failed my teachers my mentors my parents myself
-- I have to take a breath, my pager went off.

A wise doctor once told me –
Being a physician is a balance:
Forcing a patient to take a life-saving medication
Versus accepting their nonadherence;
Patient autonomy, the patient as his own advocate
Versus paternalism and authoritarianism;
Letting myself cry from sadness
Versus hiding my pain from patients;
Detachment and objectivity
Versus holding her hand and comforting her;
Sharing personal stories as though I’m a friend
Versus wearing a white coat, a picture of professionalism;
Interrupting with pointed questions
Versus letting the patient tell you his story, his way;
Listening to what she is saying
Versus ignoring what she is not saying, too scared;
Slowing down for small talk
Versus being too rushed to hear the response;
Being respectful and polite and kind
Versus making macabre jokes to try keep my soul alive;
Knowing what I’d do for myself in his situation
Versus telling my patient what I think he should do;
Giving medicine to take away her real pain
Versus fueling her raging addiction;
Spending nights in the hospital with the sick, the dying
Versus spending time at home with my family, living;
Medicine as something that I do
Versus medicine as something that I am.

Nervous. Excited. Elated. Terrified.
I’m graduating from medical school,
Sitting amongst fellow doctors.
Through all that I’ve gained, so much of myself that I’ve lost.
Reached the end of the conveyor belt,
A process completed: I’m a physician.
Forever still practicing, still improving, still learning:
So much ahead of me.
I’m not ready.
I’m not prepared to stop the act, to start the job.
It’s the end of this, but of the rest: just the beginning.