Maybe You Should Talk to Someon - Lori Gottlieb Page 0,36
as a nine blade”) but now she was distracted by shouts from the Maude Squad watching her work. The deeper she sliced, the louder the shouts became.
“Ouch!”
“Eww!”
“I think I’m gonna puke!”
More classmates came over to watch, and a bunch of male students started dancing in circles and guarding their crotches with their plastic-protected textbooks.
“Drama queens,” Kate muttered. She had no patience for squeamishness—she was going to be a surgeon. Refocusing, Kate used a probe to locate the spermatic cord, then grabbed the scalpel again and made a vertical incision along the entire base of the penis, so that it split open into two neat halves, like a hotdog.
“Okay, that’s it, I’m outta here!” one of the guys announced, and then he and several of his friends ran from the room.
The final day of the course, there was a ceremony in which we paid our respects to the people who had let us learn from their bodies. We all read personal thank-you notes to them, played music, and offered blessings, hoping that even though their bodies had been dismantled, their souls were intact and open to receiving our gratitude. We talked a lot about the vulnerability of our cadavers, exposed and at our mercy, cut open and scrutinized, millimeter by millimeter, samples of them literally put under a microscope as we removed their tissues. But we were the truly vulnerable ones, made more so by our unwillingness to admit it—we were first-years wondering if we could hack it in this field; young people seeing death up close; students not knowing what to make of the tears we’d sometimes shed at the most unexpected moments.
They had told us to pay attention to our emotions, but we weren’t sure what our emotions were or what to do with them, anyway. Some people took meditation classes offered by the medical school. Some thrived on exercise. Others buried themselves in their studies. One student on the Maude Squad took up smoking, sneaking out for quick cigarette breaks and refusing to believe he’d end up tumor-ridden like his cadaver. I volunteered for a literacy program and read to kindergartners—how healthy they were! How alive! How intact their body parts!—and when I wasn’t doing that, I wrote. I wrote about my experiences, and I became curious about other people’s experiences, and then I started writing about these experiences for magazines and newspapers.
At one point, I wrote about a class called Doctor-Patient that taught us how to interact with the people we would one day treat. As part of our final exam, each student was videotaped taking a medical history, and my professor commented that I was the only student who’d asked the patient how she was feeling. “That should be your first question,” he told the class.
Stanford emphasized the need to treat patients as people, not cases, but at the same time, our professors would say, this was becoming harder to do because of the way the practice of medicine was changing. Gone were the long-term personal relationships and meaningful encounters, replaced by some newfangled system called “managed care” with its fifteen-minute visits, factory-like treatment, and restrictions on what a doctor could do for each patient. As I moved on from gross anatomy, I thought a lot about what specialty I might choose—was there one in which the older model of the family doctor survived? Or would I not know the names of many of my patients, much less anything about their lives?
I shadowed doctors in various specialties, ruling out the ones with the least amount of patient interaction. (Emergency medicine: exciting, but you rarely see your patients again. Radiology: you see pictures, not people. Anesthesiology: your patients are asleep. Surgery: ditto.) I liked internal medicine and pediatrics, but the physicians I followed warned me that those practices were becoming far less personal—to stay afloat, they had to cram in thirty patients each day. If they were starting out now, a few even said, they might consider another field.
“Why become a doctor if you can write?” one professor asked after he had read something I’d written for a magazine.
When I was at NBC, I worked with stories but wanted real life. Now that I had real life, I wondered if, in the modern daily practice of medicine, there’d be no room for people’s stories. What was satisfying, I discovered, was immersing myself in other people’s lives, and the more I wrote as a journalist, the more I found myself doing just that.