Sunday, September 26, 2010

Sea of White

The new first year medical students filled the auditorium floor, a sea of white coats.

The UCSF Alumni center president provided some interesting advice to this eager group of soon-to-be doctors.

"Now do not get khaki. Even butchers wear white coats."

I recently attended the white coat ceremony to celebrate the induction of the class of 2014. I had a unique perspective--that of a fourth year student and of a photographer capturing the key moments of the ceremony.

When our Dean stood on stage to introduce the 150 first year medical students, I was struck by what she had to say.

"You are just starting. And in about 45 months, you will be attending another ceremony--graduation."

It's interesting how graduation lurks ahead, and I feel like I just started--eager, excited, and ignorant, just like this new batch of students.

Three years later, I feel like I have grown a litte bit, but at the same time, feel like I have so much more to learn.

In addition, I find so much more meaning in the Oath of Lasagna, a modern-day version of the Hippocratic oath, that the newly coated medical students recite in unison to culminate the white coat ceremony and commence their journey into medicine.

I have included it below. I'll be reciting it again about nine months from now...

Oath of Lasagna

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.


Thursday, September 16, 2010

All Eyes on Me

Do you ever get the feeling you are being watched?

When I sat down in the reserved chair, a part of me was a bit anxious and part of me was scared. And there was a small part that felt calm and ready to take on this challenge. Having finished three years of medical school, I have learned that sometimes courage is all you have at the end of the day, and that is ultimately what takes you a step further.

So, I sat there. I could just feel all 100 eyes starting at me, taking me in. Analyzing me, the way I sat, what I wore, my choice of shoes, my messy hair style, my overstuffed and sullied white coat. They were all processing the minute details that defined me--I am sure. It was not so long ago that I sat in their seats doing the same. I shut them all out and just focused on the task ahead of me.


In medical school you are always being watched. You are supervised at every step of the way. At times, it's comforting knowing that someone double checks everything you do, from writing a note to writing an order to performing a physical exam. You always have confirmation. But at the same time, you also find yourself wanting to develop autonomy and independence to prove to yourself that you are capable of being a doctor, who will one day be responsible for patient lives (on your own).


My patient was fifty-something year-old woman. Her dark brown hair was neatly party. She had dark red lipstick and blue clothes. She sat down in front of me. And I began the interview. She had abdominal pain and her son was recently hospitalized in the ICU after a motor vehicle accident.

It was just like any other interview and I focused on my patient in front of me, fading out the sea of white coats.

There were over fifty first year medical students watching me perform this interview for their doctoring class.

I got through the interview and was able to an adequate patient history, while drawing on the clinical pearls they taught is in the first two years of doctoring class.

By the end of the interview, I looked out and saw the glowing and exciting faces of the medical students. They are just in the first week of their training and I could see the excitement in their eyes, the same excitement I had in my eyes three years ago, which I hope I can carry with me in the years to come, when I am not being watched.