A-B-C.
When we were five, those were the first letters we learned. When we were eight, we sang along to Michael Jackson – as easy as 1-2-3. When we got into middle school, we pranked each other asking if anyone wanted some ABC gum. In college, those became our grades. And also possibly our favorite TV channel.
And now after four years of med school, ABC has taken on even more meanings for us. Airway, breathing, circulation. Asymmetry, borders, color. Airway, bones, cardiac silhouette, diaphragms, everything else.
Four years ago, four years seemed like a very long time. Who would have known that this day would come so quickly? That we would be just minutes away from turning our tassels, seconds away from receiving our diplomas, that piece of paper worth a quarter of a million dollars in loans? How did we go from repeating our mantra of “Pass = MD” and “fake it ‘til you make it” to right here, right now – when we will officially have two extra letters after our names, and the formidable Dean Thomas would soon be calling us Doctor?
Someway, somehow, we made it. We made it through CVRR and histology, knowing that if in doubt on a Cochard question, the answer is always splancnopleure. Made it through never-ending MDM lessons about sensitivity vs specificity and afternoon COM classes on how to SEGUEway into discussions on bad news. Made it through sleepless nights working on In Vivo skits and FUSION dances, and long days of studying in Tarry. Made it through sensitive exams with standardized patients, trying to cover up our embarrassment with intellectual questions about physiology and anatomy.
I remember how daunting prerounding and rounding seemed. How I would try to get to the hospital early to read consult notes and nursing reports. Waking up patients to ask about fevers and trying to come up with polite ways to ask about flatulence. I’m still amazed by our attendings’ patience, as we stumbled through oral presentations, making our way through normal chem values and CBCs, remarking on unremarkable physical exam findings, and presenting our laundry list differentials of zebras and canaries.
Somehow, it all became second nature. My first H&P took me three hours, and I didn’t even get to the P part before my patient fell asleep on me. Now, thanks to our surgery rotation, we all can get a history in less than five minutes. And the patient doesn't even need to be conscious.
As they say, every patient is a learning opportunity.
Our patients – who let us into their lives and showed us that medicine is much more than just knowing pathophysiology. Our patients, trusting us with their lives, answering our regimented OLDCARTS questions to the best of their abilities, even when our questions didn’t make any sense at all – like “can you please characterize your nausea” or “where does your fever radiate?” Our patients who are motivated to keep going in the face of metastatic cancer, or proud to show us the dignity of dying. We know their secrets, and we’re privy to some of the most private of scenes, whether it be their last breath or their baby’s first.
To our families – thank you for understanding why we seemed to disappear off the face of the earth two weeks before every exam without fail, and then emerge in a euphoric, alcohol enhanced state. Thank you for sending money – no questions asked - when our financial aid went low, and we needed money for “books” and “laundry”. Thank you for tactfully bringing up the time difference when I called in the middle of the night, but only after I was done wailing about how I was never going to know all the steps to the Kreb cycle. And thank you for reminding me of all the reasons why I wanted to go into medicine, especially after a particularly bad ER shift in which I had to disimpact three patients, another patient had thrown up all over me, and I swore that if I never saw another perirectal abscess it would still be too soon.
But I know without a doubt, that I would not be standing here today if it weren’t for a very specific group of 174 people – the class of 2011. I remember walking in to Hughes on our first day of lecture nonchalantly, not knowing that I was about to make 174 lifelong friends. People who would discover the smell of lochia alongside me, the thrill of closing our first incision, commiserate about mean attendings, and know exactly what to say after a patient death. These are the people that I was always excited to see on IDM days, excited to hear their stories as we all figured out our futures over cookies and milk. These are the people that I learned from and learned with. They were the foundation of my education, the people who helped me up when the going got tough, the friends with whom I’ve shared stethoscopes and audionotes.
So here we go. Out into the real world, out into the world to become real adults, out into the world to start paying off our loans, out into the world where we'll have the drop the 'student' adjective before the 'doctor' part when introducing ourselves. And if you start to feel a little bit anxious, well, remember these ABCs.
A – appreciate the education that Northwestern has given us. Appreciate how much we’ve learned in just four years. Appreciate what our patients have taught us and will teach us in the future. B – breathe. When you’re running to your first code, or you get your first page about a nightfloat patient – breathe, and remember that you’ve been trained well. Breathe, because you do indeed know what you’re doing. And C – call. Call on me, call on the person sitting next to you, call on your classmates. We all share the bond of having survived medical school together. Except we did so much more than survive; we triumphed.
So, the night before intern year starts, or when you’re stuck with writer’s block writing an NIH grant proposal, or even after you’ve successfully delivered your first baby on your own, call on us. Let us help each other commiserate. Let us help each other celebrate. Because we are more than just the class of 2011. We are a family.