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I was sitting in the coffee shop today, and I must have looked a little miserable as I kept running my hands through my hair surrounded by papers trying desperately to get work done. I guess I did, because two guys sitting a few spots away called out to me and asked if I was a third year medical student. Surprised, I looked back at them and they smiled and said, “it gets better.” They had seen the OB-GYN textbook I had lying buried under a pile of papers I was reading and working on, and figured that was the source of my apparent angst.

Funnily enough, it wasn’t. I was knee deep in a long paper on end of life ethics that was challenging to write, and hadn’t yet cracked the textbook that day.  I did, later, and it wasn’t quite as much joy as a tub of ice cream or a nice long run, but it wasn’t agony. Their conversation did give me pause though.

The first two years of medical school aren’t pleasant, no matter what school you go to. The process takes the top 5% or so of students based off their scores and grades, all typically Type A personalities and pushes them into a room together where they’re then tested and graded.

We go from being the valedictorians or the smartest people around, to being that dreadful word- average. Our psyches and our selves can hardly adjust to the change from achieving a routine 93 and being vaguely pleased to the pressing fear that this test may be the one that pushes you below 70. If it doesn’t, you then start looking for a yardstick convinced the exam must have been easy then. You go from being the person people look at and think, wow they’re smart, to feeling like an impostor who got into medical school as an elaborate cosmic joke. Sometime in the first two years, you’ll think about quitting. Maybe even every day. You’ll look at the books and the piles of lectures, and think “how can I ever learn this stuff?” You’ll go and learn to see patients and consider it totally a waste of time when you could be studying for the important stuff like enzymes that catalyze reactions. You’ll likely live your first two years in fear, dread and a caffeinated high that when you crash will lead to weekends ‘wasted’ in sleep.

It’s not a pretty picture, and to put it bluntly, the first two years of medical school are horribly rough- for some people. There are some in my class who excelled in the first two years, loved the minute details and the never ending reams of paper to read. They did very well in the first two years and likely loved it. I wasn’t one of them. I didn’t like the never ending memorization with what seemed like minimal to no usage of what we learned. In college, I’d thought I was book smart, believed it with all my being. In med school, I learnt how very wrong I was. The first two years of medical school weren’t fun for me, but they weren’t pure agony either. Like anything else, they were marked with periods of good and bad- but I will say that they make you feel like a fool often, grasping for details you missed. There were days I considered quitting, but it died pretty quickly once I remembered the debt I was in!

That said, I’m one and a third rotations into third year, and I’m rediscovering my passion for medicine and what brought me in here. I’ve been seeing people, actual human beings, not just anatomical drawings of them and the hard oak of a library desk with a blank wall beyond. I’ve even been helping them sometimes. I’ve been doing things like listening to hearts, taking histories, making diagnoses. On this rotation I may even get to deliver a baby. Some of the nurses took to calling me “Doc”, a word I’m not at all used to. When they’d ask me what to do with a patient, I’d actually feel as though my toils and my labors weren’t in vain. So, I still spend a fair amount of time with my nose in my books, I don’t have as much of a social life as I’d like, and most of my meals are spent in the company of my favorite TV show. But, it’s much better because my reading, my work, my toils are all towards a readily apparent goal. What I learn today in my readings may well help my patients tomorrow, the next week or the week after that.

So, for those of you still in the depths of the tunnel with only a faint light trickling in at the end of the tunnel, know that it does end, and you will survive. Your misery, your minimal social life, and your never ending time with the books will have purpose and meaning. Till then, I’ll leave you with this story from one of my favorite books (Blue Collar, Blue Scrubs, which I highly recommend  by the way).

There was a person (who’d later become a Mayo Clinic trained Orthopedic Surgeon) working throwing rocks. That means that someone would go through and use a jackhammer to break down huge segments of concrete and this future surgeon would go behind him lifting 100s of pounds of concrete- ass outstretched in correct lifting posture, and bending his elbows he’d throw them into a truck. His boss, when he would begin each day would call out, “I don’t want to see anything in the next twelve hours but asses and elbows!” So, for the first two years focus on keeping those asses and elbows moving. It does get better after.

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