Student Clinician Keynote Address
Student Clinician Keynote Address: Maura Quinlan, MD
Maura Quinlan, MD
Assistant Professor of Obstetrics and Gynecology
Clerkship Director, Obstetrics and Gynecology
The following essay is an extract from the Keynote Address delivered by Dr. Maura Quinlan earlier this summer at the Student Clinician Award Ceremony on June 22, 2006.
A student who just finished her third year said that I should tell you that this year will be different from any other year in your life because every day you will see something new. Some of your most vivid memories of patients you will know over your career will be those of your third year. You never forget the first time you hear a heart murmur, see a patient in the ER with acute psychosis, see an open abdomen in surgery, or help to deliver a baby. And it begins next week.
I remember being in your shoes, having finished the basic science years, getting out my white coat, loading up my pockets, and being terrified. I remember feeling like an imposter. I felt like I couldn’t possibly be prepared for taking care of sick people! I remember saying to my boyfriend at the time (now husband of fourteen years), "how can I know what to do, how can I evaluate people in the ER, do surgeries put it all together?" He looked at me, kind of confused, and said, "It's not like you're the only one there!" I was there to learn. I was ready for that and so are you.
Even the most esteemed faulty were once nervous third years. One of my department's most senior faculty members tells us that on her first day the senior pediatrics resident asked her to check the I's and O's of the children on the service. I is input (usually how much IVF a patient has received), and O's means output (urine volume). She, of course, had no idea what I's and O's were, but thought they meant eyes and noses, so she went to the several kids rooms, and checked their eyes and noses. She took notes, and proudly went back to the conference room to report on how the kids all seemed to have normal eyes and noses. She said that her team was very nice, and tried not to laugh as she reported her findings. It was an honest mistake, and we all make them. So, when you see our best, most senior faculty, know that they were once third year students, and they all have their stories.
So, what exactly is different about what you are about to do? You are about to see your real patients. Your patients in that you are a part of the team taking care of them. You need to step forward and participate now; you are not just an observer. And these are real patients, not simulated patients, or volunteers acting like patients, but people who have rich lives outside of here. That thirty-eight year old woman who was getting a bone marrow transplant to cure her leukemia was lab values, drug doses and daily notes to the team taking care of her. But to me she was my sister in-law, Margaret, who used the fax machine on the floor to send her son back his reviewed math homework. And, they are patients, which means that they are in a very challenging situation. Imagine what it would feel like to be in the hospital for the second time this month, for chemo that seems not to be working. Or imagine being in pain. We need to try to put ourselves in their shoes and allow them to keep their humanity as much as possible. There is no excuse for us to be critical of patients and their families if they are angry, challenging, or difficult; we might well be too if we were in their shoes.
So, what advice can I give you about how to care for your real patients? I can tell you one very important thing: remember what a privilege our patients have given us to care for them. They are literally putting their lives in our hands, and we need to give them the care they deserve.
As students, you have even more a privilege, in that they are allowing you to invade their physical space, ask them questions that they wouldn't share with close friends, and look into their bodies during surgery-all because these patients understand that is how doctors learn for their future patients. What you need to do in order to thank them for letting you learn from them, is to learn all that you can. Because these patients are letting you in, you are just not allowed to be bored or cavalier-you owe it to them to learn.
Some of the most exciting moments of medical school begin next week. You are ready, and your teachers and patients are ready. Welcome to third year, and welcome to clinical medicine.
