Medical students live a different life to many of their peers at university. For starters there tends to be a building that is dedicated to medical students, usually named “The Medical School” which straight away creates a barrier to the rest of the university. Medical students also tend to be drowned in the constant flow of lectures, seminars, cases and the occasional piece of coursework. This is until, clinical years begin.
Clinical years can be likened to a coming of age ceremony. Firstly, a hospital is allocated, and then inductions begin, with favourites including IT familiarisation, Data protection guidelines revisited, CPR sessions, Fire lessons, and family favourite – Health and Safety. After these occur, a new shiny name badge is bestowed upon the recruit, and a rather clean lanyard that will not be washed by the wearer.
From here, students set about learning in different ways, this could be in small group teaching sessions in a classroom, visits to other institutes, working with allied healthcare professionals or walking in the shadows of those who graduated before us on their day to day work.
During my clinical years, I chose to shadow as many doctors as possible, listing down my cases, and reading up on them as I went back home in order to consolidate my knowledge. This gave me the theoretical component I required, along with allowing me to practice history, examination and time management skills. It gave me a true insight into what it was like to work within the machine of the NHS. I saw all the paths of a patient, from the broken ankle from a sporting accident, to the domestic abuse victim, from the overdosing heroine addict to the seizure prone epileptic and finally from the first screaming moments of life, to the last breaths of life.
Whilst I had not seen this person die, I could certainly feel it in the atmosphere. I had been working on the ward for a week or so shadowing doctors and had come to know the patient from ward rounds. However, the day came where they unfortunately succumbed to their illness and I was called along with the on-call doctor to pronounce death. I was asked to examine them first.
I knocked on the door, waited for a few moments, and then entered the room with my colleague, closing the door as we went in. The noise in the corridor became barely audible. A sheet was left over the patients face. “Hello, Mr Smith how are you”. There was no answer. “I’m just going to check your jewellery on your arm”. I looked down at his wrist and saw his patient identification band. “I’m just going to rub your chest”, I put my fists together and begun to rub on his sternum – no response. “You may see a bright light in your eyes now”, I pick up my torch, and shine it into his eyes, assessing his pupils. “I’m just going to have a feel for the blood vessels in your neck” I put my index finger and middle finger together and touch his neck, noticing that it is still warm, unlike the cadavers from the dissection room. “I’m just going to have a listen to your chest”, I listen carefully for heart and lung sounds, but hear nothing. I check for a pacemaker and did not find one.
I tell my colleague that I believe that this patient is deceased. He repeats what I have done onto the patient and gets me to help him fill in the notes.
Whilst it took me a while to go through the examination, talking through and still treating them as though they are alive got me through it, and reminded me they were once alive.