“Your destination is on your right.”
That can’t be right. The building is a nondescript warehouse, resplendent with an old mint-green roof and white-washed walls. After a slow drive-by and u-turn, I park cautiously in the small parking lot wrapped around the building. I had arrived a little before the noon start-time of the Saturday shift at Shade Tree Clinic. Unsure of where to enter, I poke my head into the waiting room of the clinic. A harried-looking medical student piling together charts at the front desk waves me to the side door and buzzes me in. Here. We. Go.
I make my way to a small conference room in the back, where I quickly join a small congregation of fellow, nervous-looking first years who are arranged awkwardly around the table where the much more confident older students sit. We review the two diseases that we had learned thus far in our medical education and come to the conclusion that we are pretty much useless. A fourth year named Joseph comes into the room, gives us a quick run down of the day, and sets us to work. I am paired with a third-year student named Sarah1, who offers me a bite of her BBQ pork sandwich while asking if she could clarify anything I was learning in class. As we go to see our first patient, she asks if I want to take the history, but before she can finish her sentence, I vehemently shake my head no, appalled at the idea of so much responsibility in my first month of medical school.2
As Sarah begins to ask our patient questions, I’m struck by how different this history taking is from my previous shadowing experiences. Usually, the doctor would ask seemingly random questions before magically diagnosing the patient within a few minutes. Sarah, however, directs her questions in a more pointed and easy to follow manner. It’s like taking a walk somewhere and being able to take in the scenery, as opposed to flying there and still not knowing how planes fly.3 Don’t get me wrong- she also isn’t perfect. There are some moments when she has to think about what to ask next, but the patient doesn’t mind, and neither do I.
It is a comforting reminder that she’s a fellow student, albeit a bit more knowledgeable, and that the path to an MD is one we walk through, not fly.4
We wrap up our chat; the patient had developed a simple case of lactose intolerance. We send him down to social work, which is also staffed by medical students. Unfortunately, that would be our only patient of the day. It seems that there is a high no-show rate at Shade Tree, which isn’t something I had thought about with healthcare. Nevertheless, the afternoon isn’t wasted as Sarah teaches me how to put on my stethoscope and telling apart real heart sounds from imaginary ones. No cases of necrotizing fasciitis or lupus-induced glomerulonephritis. A day that wouldn’t even air as a two second clip in a House episode, yet one still intoxicatingly exciting in my eyes. It was my first patient contact, and more importantly, my first glimpse at what I could accomplish in a few short years at Vanderbilt.
1I forget her actual name. It was a long day for me. Sorry Sarah.
2To any future patients out there, I have gotten over this fear. Somewhat.
3Still no clue.
4And occasionally stumble. Ok, a lot.