Student Notebook

The old college try

By Rebecca E. Glover

Illustration by Suzanne DeJohn

Dressed in my one and only suit, I took a seat near the middle of the lecture hall. I'd arrived a little early for my first morbidity and mortality conference—or "M&Ms," as the meetings are known to doctors and residents.

These weekly lunchtime sessions detail the complex path of a given patient's illness, and the physicians in the room attempt to "solve" the medical mystery by the end of the hour. I had been able to get permission to attend the M&Ms because I was an intern at Dartmouth Medicine magazine.

Soon, a doctor flopped down on the chair next to mine, pulled out some carrot sticks, and started to munch. Between bites, he said, "You know, I was hired three weeks ago—I'm a hematologist—and I've come to two M&Ms since then. And you know what? They've both been hematology cases! What are the odds?"

Odds: I nodded and smiled, having, of course, absolutely no idea what the odds were.

Eventually, that day's presenter stepped up to the lectern and began discussing the patient's status upon admission—which was more or less unintelligible to me, except for the fact that the patient was very unwell—when the doctor next to me snorted into his milk. "See? Hematology again!" he whispered loudly. "What are the odds?"

As the hour passed, he pointed at the screen, scribbled down some numbers on his pad of paper, and eventually even abandoned his carrots. His focus was completely on the case, on what he could contribute to the discussion.

By the end of the hour, I wanted to sprint out of the conference room, take the first bus back to Hanover, and study as hard as I could so that, someday, I could possess that kind of knowledge.

This experience was one of several that convinced me to say three words that could change my life: "I am premed." Like hundreds of other current Dartmouth undergraduates, I plan to become a doctor. How did I make this decision? How do any of us? A few of my peers have parents who are doctors. They say things like "I became interested in medicine when I was three, while reading my father's subscription to Cardiology/Hematology/Gynecology Weekly."

Windows: But for most of us, it's not so easy. So we shadow doctors, we volunteer, and we read point-counterpoint articles that weigh job satisfaction and comfortable salaries against the headaches of malpractice suits and the long years of study. In short, we look for windows into what it means to be a doctor. I spent this past summer looking through several of those windows.

For part of each week, I was an intern at this magazine—researching a variety of complex topics, interviewing doctors and health-care administrators, writing articles about their work, and also learning the intricacies of such matters as proof-reading and fact-checking.

In addition, I spent Thursday afternoons as a volunteer on DHMC's psychiatric ward, something I've done now for more than a year. The fact that psychiatrists have the nerve to try to resolve diseases that are still physiologically incomprehensible is what first drew me to consider going into medicine.

On the psychiatry ward, I also became aware of patient issues that, while not necessarily medical in nature, are just as important as the actual courses of treatment. If an early-onset Alzheimer's patient thinks you are her daughter, can you play along? If a hypochondriac complains about pain in his arm, can you give him a saline shot and pretend it's a real painkiller? If family members come outside of visiting hours, can you bend the rules? (So far, I've found the answers to be "yes," "absolutely not," and "sometimes.")

I have actually found the psychiatry ward—even with all the questions raised there—to be a reassuring place. I like knowing that when I see the doctors, nurses, and other staff members pretending to be guests at an Alzheimer patient's imaginary tea party, they're doing their jobs.

Shadowing: And Mondays found me shadowing Dr. John Gemery in the Interventional Radiology Unit. I spent these 10-hour days watching intently as Dr. Gemery threaded wires up veins or performed vertebroplasties or other procedures. I scrubbed in with the medical staff and put on 20 pounds of lead (to protect myself against the radiation). Then I stood on my feet for four or five hours at a time—though, from what I hear, that's nothing in the world of surgery! As an undergraduate, there wasn't anything I could do to help. Still, I felt like a demigod as I stood near the patients in my medical outfit and observed the procedures.

I fully realize that these windows into medicine gave me only a partial view of what it means to be a doctor. To be honest, I'm still not sure that I know enough about medicine to know for sure that I want to be a doctor. Maybe veteran physicians reading this will laugh at my naivete. So be it. I know there's no guarantee that I'll make it to the end of the path and become a physician. And I know that even if I do make it, there's no guarantee that I'll be happy. But what I learned this summer is that I would like to try.