thin air

i saw a patient in the icu today who is still in the back of my mind as i try to study for another three finals. he was an old man who kept trying to cough the fluid from his lungs. his eyes were open and he's seemed completely awake and aware, though he didn't look at me or the resident as we walked in and out of his room. i wanted to talk to him. he seemed so alone in that room, staring up at the ceiling and trying to breathe as nurses and doctors went about their work checking the instruments or updating files. though i wanted to just hold his hand and let him know that he was still alive and not being ignored, i felt that as a medical student not directly involved in this patient's care, this was not something i was supposed to do.

it's still early for me to be in the hospital. rotations start next year, and at that point, we'll be at the very bottom of the totem pole. we will be at the tail end of that "team" of doctors you see rushing around the hospital in movies (and in real life). long white coats, followed by a trailing veil of short coats. our goals that year will be to keep up with the doctors and residents, not get in the way and try to catch everything they say so we can look it up later and not look like idiots next time they "pimp" us for information. so we will be there, but we will be completely stipped of initiative and identity.

right now i already feel this invisible. no one seems troubled that i look at patient's charts as i move from one room to another in my little white coat, but i feel that i would be crossing a big line if i randomly began talking to a patient. maybe this is just my paranoia, but the culture of a hospital - at least my experiences in them - has taught me that where medical students are concerned, the doctors and nurses of the hospital come before the patient. for me to make a connection with "someone else's" patient without that person's permission, would be inappropriate.

it is a strange feeling and one tinged with helplessness. many of us entered medical school after taking some time off and "living in the real world". we know what kind of doctors we want to be and have the personal confidence to be in a supportive role of people in our care. yet, the structure of medical school is still aimed at young people who have barely functioned in the adult world and lack that identity. the school hopes to mold them into caring physicians, but it must first accomplish it's goals of training them in medicine. this leads to an incredibily incongruent experience for many of us. when someone turns to me for comfort in the hospital, i have to defer them to their nurse because i should not get in the way of their "care". when we are"learning on" patient, we put them through procedures that have no benefit to their health care. many doctors in charge of getting patient consent for these student experiences are not completely honest with their patients when they ask permission for us to work with them (what ER patient would want to consent to a 3 hour interview and physical exam by a medical student when they are have just finished waiting 6 hours just to see a doctor and they aren't feeling well?)

these experiences put us into a frustrating space: dishonest to the people we have been and want to be, dishonest to the people the school wants to turn us into, but doing everything right for who we are right now.