Resident Physician Contributing Writer
Drexel University College of Medicine
Marc Katz is a first-year internal medicine resident interested in pursuing a fellowship in cardiology. He writes about the hidden curriculum of medical school and residency and about humanism in medicine.
Residency is hard. Anyone who tells you differently needs a stat GI consult because they’re full of it. You will be tired physically, mentally, and emotionally, regardless of what specialty you enter.
From the moment I set foot in the hospital as an intern on June 24, 2016 at 4:55 a.m. to the present as I write this reflection, my life feels as though it were playing in fast forward. It is hard to believe Match Day was almost a year ago.
March 18, 2016. I had been anticipating this day for months and I could not believe that it had finally arrived. I woke up that morning, sat on my couch, and began to journal as I do pretty much every day.
“Daddy, time to wake up! It is morning time!” I open my eyes to our four-year-old daughter at the foot of the bed smiling, her hair meticulously braided. I get up and wake her younger brother from his crib and carry him downstairs. The baby is still sleeping.
“Bunny!” my mom shouted from the foot of the steps, hurrying me out of bed the morning after my medical school graduation. She used the childhood nickname that came from my brother who was unable to pronounce “Dominic” as a toddler, a name that had stuck well into adulthood.
The word “gestalt” is thrown around constantly during medical school, residency, and beyond. Although never specifically taught, we all develop an idea of what gestalt means — impression, clinical intuition, gut feeling, something we are meant to develop over time.
I knew what was coming before it happened. She was looking up at the ring of white coats encircling her hospital bed, eyes darting from side to side to follow the sequence of their voices when suddenly, her lower lip began to quiver. And with her quivering lip, her breaths came faster and she sucked in deep gulps of air between her pleading questions. But soon the pack was headed on to the next patient on rounds. She was left alone, and the tears rolled freely.
I was one of only eight African-American students in my medical school class of 214, and now I am a part of the less than four percent of African-American physicians in this country. My personal and professional experiences have further invigorated my passionate interest in public health and to explore effective strategies to reduce health disparities for minority populations in the United States.
As we discharge another patient from the intensive care unit, we celebrate a job well done. “Can you believe how far she’s come in the past few weeks?” or “I didn’t think he would be able to go home so soon.” With the use of modern technological advancements, we are able to bypass the heart and lungs of patients, and push the limits of life to as early as 22 weeks gestation.
She was talking to another attending when I recognized her voice from around the corner. As a third-year medical student, I wanted to look busy, so I moved briskly, avoiding eye contact, trying to make it seem as if I were headed somewhere important.
One of the most poignant and gut-wrenching examples I’ve witnessed of the interplay between the social determinants of health and clinical practice arises in a particular patient population: those who suffer from addiction.
Ana sits on the exam table in front of me explaining how, in three short weeks, her mother will evict her from her childhood home. She is eight months pregnant and is studying night courses to become a paralegal. As her prenatal provider and primary care physician, I have been sending referrals to numerous community agencies in hopes of securing housing at the local YWCA.
Resident Physician Contributing Writer
Melissa Palma is an Iowa-raised daughter of Filipino immigrants and aesculapian advocate. She trained in family medicine at safety-net community health centers and is a board-certified Preventive Medicine and Public Health physician in Chicago, IL. Her writing reflects on the privileges and responsibilities we have as physicians to advance health equity for our patients and our communities. When not in clinic, you can find her reading non-fiction while nursing a taro boba tea.
