Category Archives: Writnig

Not About Me

12 Monday Mar 2018

Posted by in Education, Medicine, Writnig

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“Write your name”, he said. I complied on a little scrap of paper. He was, after all, the senior in college who’d just gotten accepted to medical school- therefore all wise and all knowing. “Now write Dr. in front of it.” Again, I complied. “If you don’t feel a little surge of adrenalin when you see that- maybe medical school isn’t right for you” he continued. I didn’t feel shit.

Standing here in the hall of the medical school I’m going to graduate from in May, I can’t help but feel he had a point. Today is Match Day, the day I find out where I’m going to be a resident physician- and if I didn’t feel shit then, I might shit myself now.

This day marks the beginning of the end of a $250,000, four year long journey, littered with hundreds of coffee cups and not a few tears. This day, is a year of tradition and torture every senior MD candidate in the country has come to with high hopes and loosening bowels.

As much as I’d like to believe this day is all about me, it’s really not. This day is about the people who’ve brought me here.

This day is about my grandfather, the first person to say with unending hope in his eyes to his cardiologist- “he’s going to be a doctor” when my tenuous grasp of cardiac anatomy in first year let me explain what we were seeing on his bedside echo.

This day is about my parents, my unconventional Indian mother who told me to go into business school- why did I want to spend my life studying away for test after test? Mom, I wonder that to this day. It’s about my stepfather, who with my mother sacrificed and worked to get me to college and beyond.

Today is about my loving, kind, girlfriend who’s put up with hours of complaining, self-doubt and moaning from this self-absorbed, terrified medical student. She who’s lifted me up when I’m down in the dumps, and knocked me down a peg when I’m far too arrogant and cocky.

Today is about the nurse in the ED who taught me how to start an IV. When she guided me through my first successful IV, she walked out of the room and whispered to me- “Wear gloves next time, sweetie.”

Today is about my attendings and residents, the ones who put up with my fumbling histories and clumsy physicals as they attempted to educate me. The ones who pimped me mercilessly, but always kindly, about how to treat Torsades and distinguish it from Polymorphic VTach.

Most of all, today is about my patients. The first life I brought into this world, and the first life that left this world with my crossed, gloved hands on her chest- this day is about the patients I learned to practice medicine on, the patients I laughed with and cried for.

As you finish reading this, I will probably have opened my envelope. I’ll probably have shown the fateful words written on that slip of paper to my girlfriend and my parents and grandparents, FaceTiming in from across the world well past their bedtime. I’ll know where the next part of this crazy ride is taking me- and maybe I’ll be the face you’ll see when you come to the Emergency Department, introducing myself as the words I wrote on that paper- Dr. Sarab Sodhi.

 

The Step

21 Tuesday Nov 2017

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Published 3 years and some weeks ago, as I finalized my list of applications into the match for residency. Now, I get to interview prospective residents and walk them around. Deja vu much!

I stood on the edge, and felt terror rise in my chest. I took a deep breath, and forced it down, screwed up the courage for that one step and I took it. I stepped out of an airplane door, with instructors holding onto my shoulders and hips and jumped into space at 15,000 feet. I thought the hard part was over- how wrong I was.

Today, I’m a fourth year medical student. I’ve completed four years of college with a thesis in biochemistry and philosophy each. I’ve survived the two years of classroom learning of medical school and all of my core rotations. I’ve taken all the dreaded Step exams. I’ve spent 4 dedicated months in the Emergency Room, taken care of dying patients, saved lives and had people die under my hands. I’ve intubated people, put in chest tubes, and made decisions that could save or kill people. Why then do I feel that same terror rising in my chest now?

Perhaps it’s because I’m on another precipice. I’ve submitted 23 applications for residency and I have 15 interviews scheduled. I’m deciding where I want to be for the next 3 years of my life and I’m trying to pick a place that will make me an excellent clinician, researcher, possible academic physician, and writer. Not just that, the place has to work with my significant other’s job and our plans to move in together. And I have to choose the place that will let me do that.

I hold my future in my hands, and I’m rudderless in the competing currents of each possibility. Each place gives me compelling reasons to come there, shows me visions of who I may become through them, and touts the successes of those who were in my shoes just 3 short years ago. The magnitude of this decision and its effects on my life and my future are dizzying and terrifying. Though I have a gut feeling that I will make my own luck and my own future at whichever place I end up.

As I fell from 15,000 feet with my instructors on either side I felt sheer terror. I fell at 120 miles an hour, screaming towards the earth. Fifty of the longest seconds later, and my parachute had opened somehow. My terror abated, I began to breathe again as my trembling hands reached for the cords and attempted to steer me towards where I needed to get on the ground.

Perhaps then this rising terror is from who I’ll be when the parachute opens. For as I step into the abyss I am a medical student- now bereft of responsibility and blame. A few short years later when the parachute opens I will be an attending physician sailing on my own steam. I’m stepping into the abyss in a few short months- I suppose my choice, as I step, decides who my wingmen (and women) will be when I’m free-falling with the terror rising in my throat.

Geronimo!

“Becoming a Doctor”

07 Tuesday Nov 2017

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I’m about to graduate residency in Emergency Medicine, and as I think back, I realize that I forgot completely about showing my blog and website some love. So, here we go- in memory of all the insanity that’s developed- a walk down memory lane. I’ll try to update and post frequently!
“Write your name on the paper,” he said. Since he was a senior who’d just gotten into medical school, and I was a simple sophomore who’d chosen to attend the session, I did. “Now write Dr. in front of it.” I complied. “If you’re reading that and you don’t feel anything, medicine isn’t for you,” he said. I looked at it again, my name with a Dr. in front of it. I didn’t feel a thing. I crumpled up the paper, chucked it in the trash and didn’t give it another thought. Until today that is.

In four days, I’ll get to write a Dr. in front of my name. More than that I get to call myself a doctor is the fact that I get to be one. In a few weeks when I start residency, I’ll be responsible for people’s lives. And that is terrifying!

It’s been a long journey, since my careless sophomore days. I went from being a cocky, know it all college student, patted on the head for my intellectual acumen to a terrified, foppish first year medical student who spent my first year lost and confused. I was petrified in anatomy, as I was constantly less aware than my classmates who with reckless abandon pointed out the vagus nerve, the mesenteric arteries and dismissed much of the fascia I believed was important anatomy. I drowned in the weight of neurophysiology, as I discovered that the brain was and remains a complete mystery to me. I threw up, in the hotel before I went in to take my Step 1 exam and was mortified when I barely made an average score. I spent my first years of medical school battling the terror of inadequacy, afraid I wasn’t good enough or capable enough.

But, in four days, I’ll be a doctor.

I was terrified that I was playing doctor this entire time. Mortified that my medical school experience was not enough, that I was unprepared for the next step. Then, I realized something.

I’ve diagnosed and initiated the management for dozens of diseases. I’ve read hundreds of EKGs and chest X Rays. I’ve brought life into this world with my own hands, and been there when it’s left. I’ve fought violently against death, breaking ribs as I tried to bring back a patient from the precipice. I’ve watched death softly take someone who was ready to go. I’ve cried for a patient, in the arms of my lover, after I first told someone they were going to die. I’ve violated the sanctum of the body with chest tubes and central lines in hope that someone would live.

My family, like families tend to, have introduced me as a doctor for a few months now. I’ve demurred, each time saying “I’m not a doctor yet.” Like my white coat ceremony I need something to mark the movement from a medical student to a physician and to mark the importance of the situation. I realize, however I’m not there yet. Though I’m getting my degree I have in Robert Frost’s words, miles to go before I sleep. And I’ll never be there. I’ll constantly be learning, making mistakes and fixing them, and forever humbled by the vast enterprise of medicine I’ve had the audacity to try to conquer.

I’ve been becoming a doctor for a long time now. The MD I get to put at the end of my name has been in the works for eight long, caffeine fueled, sleep deprived years. I’m going to spend the rest of my life living up to the promise it holds though- because that’s what becoming a doctor really means.

The Evolution of a Medical Student

12 Tuesday Aug 2014

Posted by in Medicine, Philosophy, Writnig

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At this moment, I’m on the top of medical student evolutionary tree. I’m a fourth year, strutting my stuff in the hospital and casually describing intubating, sticking and poking people. A few days ago, I got to run a book discussion for the new first year medical students.

As I walked into the medical school I walked down memory lane a little. I relived the boring hours of my first years orientation and how little it oriented me to medical school. I relived the shock of my first day of anatomy, and how I was told to “go read” since my group didn’t dissect that day- but I had no idea what to read… I remember how I felt, going from a cocky, confident, relaxed college student who was big fish in his little pond to a medical student who was surrounded by people who were smarter and studied harder. I remember the feelings of inadequacy when I didn’t get an honors grade on an exam, or it seemed that my peers were so much more clued into a concept than I. I remembered feeling like I didn’t belong- that somehow I’d crept into medical school and would be discovered and laughed out.

I recalled how magically in my third year of medical school, when I was seeing actual patients my strengths came out. I could talk to people, get a good history, make a solid differential and decide how to work them up. I could explain in non-medicalese why I thought they needed something and work with them when they didn’t want it. I remember beginning to enjoy going to the hospital, feeling like I was where I could do good work, where my actions and my words meant something. I remember the first time I was called “Doctor” in the hospital and how I meekly responded, I’m just a medical student.

I remembered how in my recent Emergency Medicine rotations, I was being given great autonomy and freedom. I could confidently walk into a room of someone who was sick and make decisions to make them better. I had acquired the skills to take care of people- diagnosis, treatment and decision making. I remembered most recently when I was leaving the room of a woman who had come in with abdominal pain how she had said in parting to me, “Thank you doctor” and I had smiled in return as I walked out not correcting her.

If you told my first year self that I was going to be who I am now in a few short years I’d have reacted in disbelief. At this moment I can scarcely believe that I was once that timid, that new or that scared.

I told the new first years some of this. I doubt they believed me. But maybe in a few years when they’re looking back at their beginnings they will.

Oh, and in terms of advice for you first years, here it is. Watch “Dead Poets Society”. Then you go and carpe the hell out of that diem.

A Labor of Love

07 Wednesday May 2014

Posted by in Bioethics, Medicine, Philosophy, Writnig

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I stood in the room, gowned and gloved, waiting for the woman to push. There was a thin trickle of sweat running down my back where the bright lights of the delivery room were trained. The baby was just short of the pubic bone, nearly ready to be born.

The mother-to-be had been pushing for hours and was exhausted. We watched the strips that recorded her and her baby’s heartbeats—each time that she pushed, her heart rate spiked to more than 170 beats/min and she closed her eyes and blew the air out of her lungs as we urged her on. “Push. Push. Push.” “Breathe. Breathe. Breathe.” We continued, our implacable rhythm timed to the clockwork contractions of her uterus.

Her exhaustion had caught up with her; I could read the defeat in her eyes as she whispered to her husband, “I can’t do it.” He smiled into her eyes and whispered back quietly, “Yes, you can.” My eyes were transfixed by this private moment between husband and wife, for all intents and purposes alone in a crowded delivery room, oblivious to the five other people standing around.

My hands moved on autopilot, assessing the baby’s position, a job my eyes should have done, as well. I stood there, doing what I was supposed to by habit—this was the fourth delivery that I’d done, after all, and I was a 5-week OB veteran. I stood there watching this moment, this beautiful, private moment, and some of life’s mysteries became clearer.

It was suddenly apparent to me how much I’d given up to be the one bringing this couple’s baby into the world. The fact that I could be welcomed into this intensely intimate moment and thanked after I’d done my job attested to the value of the profession I was joining. But in this moment, I wondered, at what cost?

This couple was a few years older than I. They had been married since they were my age and were having their first child now. They were madly in love, had jobs that fulfilled them, and were bringing their first child into the world.

At that moment, I had one purpose, one raison d’être, one thing I was searching for—that obsession, that passion, was medicine. In pursuit of it, I’d given up my hours, my sleep, my financial future, my social life, and my relationships.

My family was thousands of miles away, rarely seen and always missed. My friends were languishing, with unreturned phone calls and text messages on my phone, forgotten among 14-hour shifts and minutiae that needed to be memorized for each rotation. My love life was challenged by my constant lack of time and impossibly high standards—not to mention my jealous, unforgiving mistress named medicine.

She pushed again, and I snapped back to the here and now. Her son was crowning, and my hands moved automatically. I checked for a cord around his neck, pulling him out of his mother’s womb, one arm at a time. He was born from a warm and safe womb into the cold and lonely world he would now inhabit.

I swaddled him in blankets and placed him on his mother’s chest as his parents stared at him with love, drinking in the sight of his fingers, his toes, his perfect little features. I finished my work quietly. They thanked me warmly as I left the room and ripped off my gown and gloves as I went, their eyes never having left their beautiful baby boy.

I smiled as I left their delivery room, lost in my bittersweet thoughts. I kept walking because my shift had been done 20 minutes ago. I walked to a house filled with books about medicine and the tools necessary for its practice—stethoscope and white coat among them. I walked to an empty house and an empty bed. I was on again in 9 hours.

Ann Intern Med. 2014;160(9):653. doi:10.7326/M13-2673