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    Doctoring Week 1Over the past few weeks, I have spent a good deal of time analyzing exactly why I

    am nervous to enter medical school. In doing so, I revisited two poignant points in mylife where I felt a similar blind apprehension. The first, I was in eight grade and wasgoing down to Costa Rica with a summer program for three weeks to study tropical

    botany. It would mark the first time I would be truly out of contact from my family for an extended period of time. The trip marked a true coming of age for meas I waslearning about different tree types, I also gained a more intimate understanding of myself.For the first time, I felt my passions lead my questions, felt a confidence and calmnesswith my gained independence and felt a deep responsibility to my classmates and myself as we hiked through the jungle and faced numerous challenges together. Two years later,I faced a whole new set of challenges as I began running cross-country for my highschool. I started running because I was bad at it. I wanted to push myself physically in away I never had and, in the process, learned about both my physical limitations and mydeterminations. I also learned the value of a teama group that provides motivation,honest feedback and constant support. More than anything, cross-country taught me how

    to push myself past my comfort zone in order to reach my goals.These rites of passage have taught me so much about myselfbe it about my passions, my fears, my limitations and my potential. I take these small lessons fromevery step of my life and look to these experiences to give me strength as I enter the nextfour years. I now know that I am driven by passion, that I can be pushed past my comfort

    point, that I feel a great deal of personal responsibility and that I care deeply aboutworking with other people to reach our common goals. Undoubtedly medical school willchallenge me in ways I have never experienced but I hope these lessons will provide mewith the strength and confidence to move on.

    As I start my next four years, I often reflect on my initial motives for applying toPLME. I was originally inspired to pursue medicine from reading Dr. Sacks books

    growing up. I loved the mystery of medicine as I viewed each case as a veritable Whodunnit? of the body. I remember even then being acutely aware that, on the one hand, Iwanted to diagnose bizarre, highly complex neurological disorders and on the other, Iwanted to work closely with patients to help them to improve their livesin my mind,medicine has always existed as a humanitarian/scientist duality. Ever since then, I havenever seen myself pursuing anything else.

    Even after my first few days in medical school, I can tell the journey will not beeasy. I have already begun to realize my new strengths and weaknesses in this new field.For instance, I can already see that, in class, one of my strengths as a learner is mytendency to synthesize as I learn. This means I take notes, ask questions and truly try tomaster a concept as it is being presented. Unfortunately, this tendency does have somedrawbacks. I tend to fall behind when taking notes, missing important information as Ifocus on the previous concept.

    Overall, I know that I am embarking on a long journey, but it is one that I am trulylooking forward to. I find medical school exciting because I know that I am finally

    pursuing a field that I have wanted for so long. The years of anticipation are finallycoming to fruition and for me, there is nothing more exciting. My greatest fear inentering medical school is failingjust as pursuing your dream is invigorating, thethought of failure is devastating. That being said, I know I will face setbacks and I

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    realize that I must find ways to take care of myself both as a student and as a physician. Ihope to find comfort in the humanity of medicineI am working with people, notnumbers or charts or figures. I hope this realization will keep me grounded andconnected with my patients. In addition, I hope to set some time aside to pursue my owninterests outside of medicine. Im hoping that a few well-chosen hobbies will allow me

    to unwind after stressful days and to gain more perspective on my patients. In the end, Ihope to be sustained by my family and friends. I have always looked to them for supportand strength in everything I have pursued and I hope they can continue to help me as Ienter this next phase of my life.

    Doctoring Week 3Over the past few weeks, as our Doctoring checklist has grown longer and longer, I havelearned to appreciate several things about taking a medical history. First, I have realizedthat how I look and how I feel are two completely separate entities. Each time I sit with anew standardized patient, I am working to suppress these intense feelings of nervousnessas I find myself directing my body in a mechanical way. The first standardized patient I

    interviewed, I was literally reminding myself to breathe before asking each subsequentquestion. This separation between a professional exterior and my true feelings was evenfurther amplified this week as we began taking sexual histories. I felt myself looking intomy patients eyes, wondering how she would react and praying that she would not feel

    judged by my words. Taking a sexual history puts physicians in a shocking position of powerwith just a few questions, we have the ability to completely alter our patientsemotions, their comfort levels, and their overall perceptions of medicine. It is then ironicthat, as we try and tread this fine line between authority and sympathy, between comfortand respect, we all cling desperately to our checklists. In a sense, I think this reflectssomething deeper about medical school as a whole: we are trained during these first twoyears to memorize before thinking. The sheer volume of information presented to usnecessitates that we just sit and passively absorb. Then, by some magical process in afew years, we will learn to turn the switch from passive learning to active diagnosing.The beauty and struggle with doctoring is it is forcing us to think much earlier than anyother class. My classmates and I focus so much on this checklist as if it is some

    barometer of success without looking at the bigger questiondid we succeed as physicians? I suspect this question means different things for all of us but for me, itmeans My biggest fear when I interview standardized patients is their response to thequestion, Did you feel comfortable during the interview? To me, this is an indicationof my ability to act as an effective and human relay between the worlds of disease andmedicine and failure here .

    When we began taking sexual histories this week, I thought back to my last appointmentwith my physician to think about the language he chose when asking about my sexualhistory. Then I remembered, he didnt ask a single question but instead chose to hand mea questionnaire at the beginning of the appointment and to then tap his pen against thetable to fill the awkward silence as I nervously scribbled away answers and circled YESor NO. I remember one question in particular: Have you had sex with a person who hashad sex with someone of the same sex before 1985? I sat there annoyed and confused,reminded of those infuriating aptitude tests from middle school with questions like, If

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    train A leaves the platform at 9:15 and train B leaves at 9:20, what will John be eating at9:30? In retrospect, I now realize that the use of the questionnaire optimizes our societys discomfort with openly discussing sex with each other. Just looking at popular culture, it is clear that we love the idea, the fantasy of sex, but bristle at the thought of discussing our own sex lives with anyone. Thinking of this provides me some comfort

    it is natural for your patients to be a little uncomfortable when you ask about their sexlives so when they start wringing their hands and shifting in their seat, it isnt necessarily because of my specific choice of words. That being said, it then places the obligation onme to be respectful while taking their sexual history and to reassure them that these

    pieces of information are important. The whole process reminds me on an article I read afew years back regarding the medicalization of addictiona societal paradigm shiftthat allowed us to view addiction as a condition and not a moral failure. Our generationof physicians has a greater responsibility to our patients to place the topic of sex within asafe space where we can discuss it openly and honestly without the hindrance of socialexpectations. Only in this way can we begin to make an impact on safe sex practices asan important component of taking care of our patients as a whole.

    Taking sexual histories has been an enlightening experience. I know I am far from beingan expert but I am excited and humbled by the opportunity to practice. I hope that as Icontinue in my medical training, I remember how honored I feel right now by the implicittrust my standardized patients place in me and how deeply responsible I feel to doeverything in my power to provide them with the best care possible.