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Student reflection: Denise Darmawikarta, Meds 2016

Monday, June 30, 2014

Friday Morning

Every medical student will have claimed, at one point or another prior to the start of medical school or over the course of their undergraduate medical education, that their purpose in pursuing a career in medicine is to save lives. While I have yet to experience the adrenaline rush and the sigh of relief upon saving the life of a patient, I can tell you that if it is anything like helping to bring life into the world, then let my journey begin!

It was a snowy Friday morning, one where each snow flake was a perfect stellar dendrite falling slowly and steadily enough so that when you looked up, it was like magic pouring down from the skies. It was also early enough that for a moment as I awoke, I almost wished I had not agreed to observe a Caesarean section on the one morning I had off that week. Almost. But as I dug into my bowl of cereal and thought about babies, I imagined how miraculous it was for a living human being to emerge from another.

When I arrived at the hospital, looking eager and still thinking about babies, I ran into a friend who was in the midst of her clerkship rotation in obstetrics. I also saw a number of other clerks and residents and I began to think to myself that my morning will simply consist of my presence at the corner of the operating room, standing on my tiptoes, as my vertically-challenged 5'1'' frame was unlikely to give me any viewing leverage, while a few clerks and residents gather around the operating table bearing true witness to the miracle of birth.

"Today must be your lucky day. The clerks and residents have academic duties. No learners in the ORs this morning but you," said my dear friend, who immediately turned my barely-concealed disappointment frown into a perfect toothy grin. As I donned a pair of oversized scrubs and put on my white sneakers, a resident pointed out that I might want to keep my black boots on, in case blood waterfalls onto the floor. "We don't want blood staining those perfect white shoes, do we?"

Slightly mortified and entirely excited, I introduced myself to the OR nurse, who suggested I introduce myself to the expectant couple. It was to my absolute delight that I recognized both husband and wife, who were my first patients in our obstetrics clinical methods session just two weeks prior. In fact, I had seen them a second time during our second clinical methods session a few days before. And then there I was, standing at the foot of Mrs. A's bed, making what I considered to be one of the most important and meaningful small talks that I had ever made in my life.

"Of course we remember you!" they exclaimed, and I silently thanked whoever aligned our paths so that I would share such an incredible experience with this particular couple.
In the following minutes, my preceptor, who had so generously extended the invitation to observe this C-section, showed up, took me to the recovery ward where another one of the patients I saw in clinic was cuddling her newborn, and showed me briefly how to dictate on a patient's chart. After a blurry montage of meticulous hand washing and sanitizing and putting on gowns, gloves and masks, I finally planted my feet exactly where I wanted to stand: right by the operating table, not ten feet away from it.

In that moment, I thought to myself that I was exactly where I wanted to be, not just on that day, at that particular time and in that particular OR, but in life. It had taken me some time and a bit of soul searching to figure out that I was going to commit myself to the practice of medicine, but as I held the clamp protecting Mrs. A's bladder and held my breath in anticipation of the baby, I knew that there was nowhere else I would have rather been.

There was blood and a gushing of fluid, and as one obstetrician pushed on the patient's abdomen while the other reached inward for the baby's head, a beautiful healthy baby girl was born, bearing the most victorious cries that filled the room.

And then a wonderful thing happened.

"Take this pair of scissors and cut the cord," said my preceptor to me. So with great awe and an ounce of courage, I severed all physical ties between mother and baby, and thus pronouncing the beginning of a whole new life.

Continuity of care

In retrospect, what I learned to appreciate the most out of that snowy Friday morning is the value of continuity of care in the practice of medicine. Two simple ten-minute meetings at a clinic were all it took to create what I believe to be a meaningful connection between a patient and me.

Thus, it came not as a surprise to me that the most gratifying part of my experience did not stem from my scrubbing in and getting to assist in a surgical procedure (don't get me wrong, this was by far the most exciting hands-on experience I have had since medical school began), but from the simple bond that was forged between Mrs. A and me the moment I stepped into her examination room many weeks ago.

It was this seemingly insignificant relationship that allowed me to understand and appreciate that medicine is both a science and, perhaps more importantly, an art.