God is so good. I don’t understand this at all, and I half don’t want to put it on here; but it is a rather important part of my experience, and I thought it might be comforting to Orac and his friends. . .

Last night I got my evaluations from internal medicine in the mail. I couldn’t believe what I was reading. It felt like they must be talking about some other student, it was so good. They were all using superlatives. I knew the heme/onc attending was impressed, but it seemed like the residents were happy with me too. The only thing they said to fix was to be more thorough with physical exam. Which I have been kicking myself continuously for, for at least the last month, because every case report and every case conference I hear, seems to turn on some detail of history or physical exam. I think I’m too lazy, I don’t look for all those details. At least this month I was able to stop having to do the physical exam in two parts, with the second one while I was writing up and discovering what I had forgotten.

Today the attending made a point of taking each student aside, because it’s his last day with us on the service. I was rather dreading my turn, because I made such an bad exhibition with the hyperbilirubinemia. I knew I deserved a lecture on preparing ahead of time, and wasn’t looking forward to it. Well, his method of giving feedback was to ask me how I thought I’d been doing in this or that area. So I said, truthfully, that I had been trying to work on being thorough, and so on. And he said that was funny, because the residents were impressed with how thorough I was. And all kinds of other things; whatever I said I wasn’t too good at, and was trying to work on, he said something very nice. I feel lazy, uninformed, and irresponsible; but apparently no one else thinks so. Maybe I will turn into a doctor one of these days.

During first year, I went to hear a panel of fourth years, giving advice about the clinical years. I’ve always remembered something one of them said: Take possession of your patients. Own them: follow everything about them, make sure everything is taken care of, don’t just figure that the intern will get it. (Of course the intern should/will, but you have to practice thinking like the intern.) When I heard that, I knew it was good advice; and I’ve been trying to do it all this year. So it was less surprising than the rest when the attending said the residents appreciated that I seem to own my patients. Neat; in spite of how it always feels to me like the interns have a secret source of information, that no matter how thoroughly I read the chart or talk to the nurses, there’s always some key piece of the puzzle that only they have. I sincerely hope that, along with all the midnight calls, I will automatically acquire that inside loop when I graduate.

My other piece of wardsmanship advice, for other med students out there, is: the residents apparently notice if you always hang around till the very end of the day, and always look for extra patients, or at least accept them with a smile. Plus you learn more if you have more patients.

Lastly, I have been running my own “experiments” (unintentionally), and I have found that taking time to memorize chapters from the Bible, and meditating on them at night or in the car always correlates to markedly higher test scores. Ever since college. It’s time well-invested. My parents taught me that from Psalm 1: “Blessed is the man who meditates in the law of the Lord day and night. He shall be like a tree planted by the rivers of water, who brings forth fruit in season. Whatsoever he does will prosper.”

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