It is early on a Saturday morning when I walk out of the elevator of Doan Hall looking for a nursing desk to call the fourth-year anesthesiology resident I am supposed to be shadowing. Instead, I am met with a set of double doors and a staff-only sign.
Before walking through the doors, I decided to read the placard placed on the wall next to them. As I begin to read, I hear footsteps approaching and turn to my right only to be met with the resident who immediately informs me of an emergency C-section that she was just called into. She instructs me to hang my white coat on the wall and grab a scrub cap. Then she speeds away.
I struggle to keep up while attempting to recollect how the doctors on Grey’s Anatomy would tie their caps only to realize that they never actually show the caps being donned on the show.
Finally, after what seems like an excessive amount of time spent trying to capture all of the tendrils of my hair in the cap (thankfully, I decided to wear my hair in a bun that day), we arrive at the entrance to the OR. I am told to put on another scrub cap and a surgical mask. Before I know it, the resident is making her way into the OR, instructing me to follow when ready.
After ensuring my preparedness to walk into my first OR, I open the door and find a safe spot behind several machines with a good view of what the anesthesiology resident is doing. The C-section is performed while the resident administers several medications and monitors the patient’s vitals. I am witness to it all. Finally, after the newborn baby is cleaned and weighed, the nurse approaches the mother and asks for consent to administer erythromycin and vitamin K; immediately, before she has a chance to explain why each would be administered.
Babies are born with a sterile gut and, therefore, lack the intestinal bacteria that produce vitamin K, necessitating the administration of this essential fat-soluble vitamin for proper coagulation so that the newborn does not experience vitamin K deficiency bleeding. After only six weeks in medical school and without even beginning any specific system blocks, I was able to apply my acquired knowledge to a clinical situation. I began to smile to myself as I realized the importance of the foundations of medicine.
The ease of getting lost in the basic science of medicine and the endless details is an unsettling reality in the life of a medical student. While medical education has seen a transformation of teaching practice from solely lectures to the inclusion of small-groups and that of curricular changes from subject- to system-based, the wealth of basic science content that is delivered to us is one part of the medical student experience that has remained constant and will remain constant in each successive generation. While each professor relates this influx of medical knowledge to “drinking from a power hose,” what they do not discuss is our mental response to this overwhelming information overload.
We often question the necessity and the utility of such extensive knowledge. Why is it necessary to understand even the most minute details rather than grasping the overall picture? Because it is the smaller details that contribute to patient care. It is easy to simply request consent for the administration of vitamin K to a newborn baby. But what if that consent is denied? How can this newborn’s caregivers be informed of its importance and convinced of its necessity without the knowledge of this “minute detail?” They simply cannot. And that is why as medical students, we are trained to see through multiple lenses: both large and small. By gaining this understanding, the future becomes more tangible, and our purpose is revealed.
Manisha Ravi is a medical student.
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