Med Skool (block 1)

Hey, how are you going?

For me, I uh just finished my first ten weeks of med school just last week – now I only have 3 years and 8 months or so to go, so I’m pretty much at the end now you could say. But for now, I get this really great one-week holiday before I get back into it. Well, actually, today is already Thursday… so the break is almost over. Ah well.

For much of the past few months, I felt like a kid who just started school. New place, new people, new set of things to do. And a new need to figure out everything again. That’s frustrating, you know. I like it when things are already figured out. So, it really has been a mad scramble trying to figure out how to do things well and troubleshoot what is happening when things go wrong. Each day involved a lot of tinkering around adjusting my expectations for this stage of life. A lot of thinking (and overthinking) later, I thought it might be good to write some things down.

So, if you aren’t already bored by this third paragraph, let me tell you a bit about what it was like, and some of the things I’ve been thinking about and experiencing in the past ten weeks. I do want to share all the cool and awesome things that happened, but also the struggles. Lots of struggles. I hope that’s okay. I’ll also show you some happy snappies that I took on my phone throughout the semester. Actually… we don’t call them “semesters” here in med school. We call them “blocks”. I know, it’s like a whole different world.

(1) Starting

Sneaky first day picture from the back of the hall

I was late to my first day of med school.

Here, I took a sneaky photo at our very first lecture – which was really just an orientation info session. Notice how I’m sitting at the very back. I think I actually sat on the ground behind everyone because it was too awkward to find a seat. I swear it wasn’t my fault that I was late. There was a train delay. I’m not even kidding. Sydney trains! But… I suppose it was also kinda my fault, because I decided to go for a train that got me there barely just on time.

Okay, I’m kidding myself. Do you want to know the real reason why I was late? It’s because my mate Aolei and I thought we were too cool for school. Before the year started, we were thinking about what everyone in medicine might be like. And we jokingly postulated – “you know, everyone is probably going to be your stereotypical med student: super intense, and stressed out, and they probably will show up to the first day an hour early or something. Aolei, we can’t be like that.” And that is probably the real reason why we were late. We picked a fairly late train, and when we rocked up, it was only the two of us who were yet to arrive. Everyone else was already there, already furiously taking notes.

In fact, Aolei and I came up with a hashtag that summed up how we wanted to approach medicine before it began – it was #KBNTK, which stands for “keen but not too keen”. We wanted to be keen, because everything was exciting and new and fresh, but not too keen. We wanted to be in school… but at the same time, beyond it. Now whilst its funny to think about these two young punks being too cool for school, I do think that there was a deeper reason (hopefully) to why we took on this perhaps childish attitude. And I think it’s because we recognised that we were about to throw ourselves into an all-consuming undertaking – that is, we were aware of the fact that medicine could very easily, in a blink of an eye, take over our whole lives. It wasn’t just the immense demands of study that would eat up all our time, but the very task of training to be someone who wields the power to heal the sick and rescue the suffering could so deeply penetrate our hearts and minds, our blood and bone marrow, and transform our innards until all our affairs and our concerns, indeed our whole lives, was nothing but medicine.

“Aolei, we can’t be like that. We need a life outside of medicine.”

We wanted to do medicine, but not let medicine do us. We wanted to be keen, but not too keen. So strangely, the first thing we did to safeguard against this “danger” was to, uh… rock up late to our first day. Good start.

(2) Learning

So, it is med school after all. And as expected, I needed to learn a whole heap of stuff. This first “block” of ours was called the foundations block, and it’s where they tried to catch everyone up to speed by cramming a medical science degree into ten weeks. Fantastic.

Fortunately, I had learnt some of the basic medical sciences in my undergrad degree. Unfortunately, there were many things I needed to learn again (and also much, much more). We had a whole variety of different subjects. Like this:

Mitochondria is the powerhouse of the cell

It’s the mitochondria! The powerhouse of the cell! How many times do you think I’ve learnt about this now? Counting high school biology, all the way through undergraduate science, probably like 23840938209. I think the worst part of learning was the need to re-learn and re-memorise all the tiny details of a subject that I had already understood. It made me cry. Not really cry. Just med student cry where, in virtue of our personalities, we say we are crying and dying, but in reality, we’re actually fine and need to stop complaining. In contrast, other subjects were an absolute joy to learn. I had never learnt anything about pharmacology before (all about drugs and what they do). Yet, our lecturer was this wonderful old man who made it so crystal clear and easy to understand – and he would always throw in at the beginning of his lecture a much-needed word about caring for those who are less fortunate than us. This was a man that we could learn lots from.

Never put profit above principle or people

I came into med school prepared though. I had a battle plan for how I was going to memorise 20 billion facts each week and retain them all by week 10. It was this little flash card software called Anki. Have you heard of it? If not, allow me to evangelise: Anki (I like to think) is the holy grail of memorising 20 billion things with minimal effort. It’s pretty much magic. So, it has this special “spaced-repetition” algorithm, where the first time you see a flashcard, it’ll show you again the next day. And then again in 3 days. Then in 7 days. Then 15 days. And so forth, with the idea being that as you get better at knowing something, it’ll show it to you less and less frequently. So on day off each week, I would go through the past week’s lectures and make flashcards. And each and every day, religiously, I would use Anki. It was just free revision each and every day.

this is Anki guys!!!

But, do you know what the problem was? Yes, I had this sure-fire way of learning everything (almost) perfectly. But that was exactly the problem. I was (perhaps subconsciously) a perfectionist and wanted to learn everything perfectly. Med school, I found, was filled with many perfectionists, yet it is probably one of the lasts place you are able to be a perfectionist. You simply can’t. You’ll get swamped. You’ll drown. And… that’s exactly what happened. By the 3^rd or 4^th week in, I found myself thinking about nothing but the giant mountain of stuff I needed to learn. Around the clock. When I lay in bed to go to sleep, I was thinking about the lectures I needed to make Anki cards for the next day. It was pathological. I was burning out already, and I felt like a hollow shell – stressed, lonely, joyless. Four weeks in, breakdown, tick!

And that was when I knew I had to seriously recalibrate my perspective. Even though I set out at the beginning of the year fully aware of the fact that medicine could take over my life, it crept up on me like a thief in the night, and before I realised it, it already had. What the heck. The danger was more subtle than I envisioned. Reset. Reset. Reset. I needed to remind myself that it was okay to not learn everything perfectly, and that yes, I still need to take care of myself.

Learning wasn’t just listening to lectures though! Here’s a happy snappy of Michael trying to take my blood pressure. Surely, the highlight of each and every week would be going to the hospital, where we would undergo all of our ‘clinical’ training. So, every Wednesday, instead of going to uni, I would go to Hornsby hospital – which, get this, is a 5-minute walk from my place.

Many people would aim to arrive at 8:30 for a 9 am start. I would leave the house at 8:55. Hehehe.

Here at the hospital, we learnt a whole bunch of things. We learnt some procedural things – like how to physically examine a patient (listen with your stethoscope and feel their tummy), as well as how to take someone’s blood pressure. I hate taking blood pressure. I can’t do it. Like, I put my stethoscope on their arm, and it rustles, and I don’t know what I’m listening for, and I can’t tell what’s what and whether it is background noise or not, and whether it’s their heart beat or mine and I have no idea what I’m doing. However, I do believe that I am confident enough to pretend to know how to take a blood pressure now.

Another really important thing we learnt was how to talk to patients. And we had a tutorial for this each week. Coming in, I thought “nah what the heck this is easy it’s just like talking to people yeah”. But of course, I realised that it was much more difficult than that. Knowing what to ask, and what to look for, and how to ask it, was an art in itself. Each week, our tutor would send us out into the wards in pairs to chat to a patient, and to find out as much as we can about them. Then, we would gather to debrief.

“Okay, tell us about Mr. A,” our tutor would say.

We would tell her, “Well, Mr. A came in last week with shortness of breath. He has asthma and uses X puffer, and also has a history of diabetes. He lives at home with his wife and 5-year old daughter.” (Insert 10 other random details)

Our tutor would ask “what day did he come into hospital?”

Well, we didn’t actually ask him that, so we’re not too sure.

“Uhhh…”

Tutor: “When did the shortness of breath begin?”

Us (unsuspecting first year med students): “Uhhh…”

Tutor: “What other symptoms did he have?”

Us: “Uhhhhh…I think he had a fever?”

Tutor: “When was he diagnosed with asthma, and by who?”

Us: “Uhhhhhh…”

Tutor: “Does he use a preventer puffer?”

Us: “Uhh…”

Tutor: “Does he have type 1 or type 2 diabetes?”

Us: “Uh…”

Tutor: “How does he manage his diabetes?”

Us: “Ummmmmmm…” (‘I…i-i-ii-insulin… I think?’ one of us might say, nervously)

And that is the moment you realise that there were 20 (million) things you should have asked that you didn’t ask. Long road ahead, but it also is so much fun, getting just a little bit better each week.

(3) People

On my first day, I discovered that our med cohort is massive. It’s about 280 people or so.

Lots of people yes

Now, this could be a little bit overwhelming at times. But you know, there was this absolutely amazing feeling in the first few weeks of med school with all these people around me. It was the fact that it felt like high school all over again.

Huh?

So, you have everyone sitting in the same lecture theatre. We’re listening together to the same teacher, and we’re learning together. And then, the bell rings (symbolically), we all go to lunch. We chill out, hang out in the playground (i.e. courtyard cafe next to footbridge lecture theatre). Then the bell rings and we all go back into class to learn some more. You stick around the same group of people each day. Every day. Between lectures when we had a 10-minute break, I would wander over to the other side of the room, make chit-chat with some friends, and then get back to work when the next lecture started. There was ample time to mess around in the midst of all the learning. One time, Ariel the mermaid was sitting behind me and because it was the Lunar New Year, she offered me this little piggy pineapple tart – how cute is that.

This is a pineapple tart.

You see, there was this astounding feeling of togetherness in those first few weeks. A very strong sense of community. And I absolutely adored this feeling. Even though lectures were intense and there was lots to learn, things felt homely, you know? Though most faces in the crowd of 280 were an unfamiliar face, I still felt there was a strange unspoken bond – perhaps potential people who I’ll become friends with soon – and it felt like we were this big family going through this ordeal together.

However, as time progressed, the initial orientation season died down and we settled into the rhythms that would define the rest of the block. For some reason or another, the sense of community (in my own heart at least) started to become thinner and thinner. Perhaps people stopped coming to lectures. Or perhaps, as we split up into different lab groups and streams, I found myself away from the people I had made friends with, to be surrounded by a crowd of once again unfamiliar faces. Perhaps as the stresses of study piled up, people would quickly scuttle off into their little bubbles do to the work that needed to be done. As the communal high from the start of med school started to wane over the next few weeks, and I found myself yearning for, but not finding, that sense of togetherness and community that I had briefly tasted just a few weeks earlier. I found myself more and more disorientated. And for much of the block, I struggled deeply with loneliness.

It’s a strange thing – to be familiar with people, indeed, to be surrounded by people for much of the day, and even to know that you have friends, yet somehow despite all these things, find yourself feeling a crushing sense of being alone as you passed the week. This was the feeling: I would walk into class and have a look around before I sat down. Sometimes, there would be people I recognised here and there, scattered throughout the room. Other times, I wouldn’t know anyone. But it seemed like everyone had already settled into their little bubbles and groups of people. And often, not wanting to be annoying, and also possibly not wanting to make awkward conversation (and then after thinking about it for a little bit, and then not wanting to overthink it), I would I would go and sit alone at the back of the lecture theatre.

Actually, do you want to know what my greatest fear was at this point? It wasn’t actually not sitting with anyone during the lecture. That was fine. Rather, I found myself terrified of what would happen after the lecture. See, usually after a lecture, people would leave with their group of friends and then go do whatever they would do. You would wait for your friend if they were caught up with something, see what they were doing after class, and you’d possibly go study or eat or whatever together afterwards. But often, I felt that this was something I didn’t have. There would be no one to “wait for me” or to “leave with me”, and if I took enough time packing up my laptop and stuff before getting up, I would find that everyone would have left already and the lecture theatre empty.

I found that there was a stark difference between merely being familiar with people, and actually having people doing med school alongside you – a community that would continue even after class was over. Perhaps this lasting form of community was what I was really looking for. And without it, there was only a sense of emptiness awaiting me after class. Everyone was gone… what do I do now? I didn’t really have anywhere to go. I didn’t want to go to the library and study… well, I didn’t want my life consumed by study, and either way, I had already done all the study I needed that day (bless Anki). There wasn’t much to do at home either. And I didn’t know where everyone was by this point, and they were all perhaps busy studying anyway. So, I felt really lost. The world felt cold and uninviting. It felt as if there was somewhere I wanted to be, but at the same time, there really was nowhere I wanted to be.

This was the emptiness that I feared for dear life. Sure I was doing medicine, and I was doing it in the presence of many other people, but damn, for some reason I do not know, it felt like I was doing it alone. And so, for much of the block, there was a cynicism and hopelessness that coloured much of how I saw things. I found it took so much effort to be happy, and hopeful, and to enjoy things – and I felt the burden of not having the emotional energy to reach out to people and make friends too. Days were long and depressing. I started to feel my motivation waning as well and didn’t really want to do anything.

OK.

Let’s pause for a second. I wanted to write about this not to garner your pity – I know that lots of you are awesome people who really care for me. Actually, I wanted to write this in case you were perhaps experiencing something similar (all the more if you are in SMP) and I want to let you know that you are not alone in this.

Things didn’t always remain in this dark and hopeless mode, and there were lots of good things to look forwards to too. But I think from all of this, I really experienced first hand how strongly we were made for relationship. As humans, we are relational creatures. This deep yearning for togetherness and community and people to walk alongside showed me that I (and perhaps you too) simply cannot survive without others. And it is a good thing to seek after community, no matter where we are placed.

(4) Rhythms

As the weeks progressed, things started to settle into a fairly consistent rhythm. There were ups. There were downs. At times there was just the dark cloud of feeling joyless and tired. At other times, I felt completely elated and excited. I had no chill. It was all or nothing.

Glorious sunrise over Hornsby station

So, I knew that Wednesday was always the best day of the week. I would always end my Wednesday’s with a big smile, and really glad that it happened. So, Wednesdays was hospital day – but it wasn’t just because we learnt heaps of cool things that day at the hospital (which is definitely true), but I suspect it might be to do with the sense of community there. At Hornsby, there are 18 of us, and furthermore, we are split into little groups of 6. I’ve genuinely loved getting to know the people in my clinical group, who are each so unique and wonderful and a delight to be around. At the hospital, it felt like I was learning alongside others, and there was always someone with whom I could share the experience of learning medicine with – which I really appreciated.

But then Thursday would hit, and I soon discovered that Thursdays were probably consistently the worst day of the week. The reason was that Thursdays was lab day, where we usually had 7 or 8 hours straight of class without any break. Lunch was eaten on the walk from one end of the campus to the other, from one class to the next. Halfway through the day, I would already be fairly exhausted, and everything sucked. At first, I was asking “whyyyyyyyyyy”, but as the weeks progressed, I knew that this was to be expected – and that was OK.

There were also other things scattered throughout the week – things that were a part of the weekly rhythm – that kept me afloat and alive. For instance, every Tuesday, I would meet up with this bunch of people in our 1-hour lunch break, just outside ABS building where we usually had class:

This is the EU ~ We meet each Tuesday at lunch hour

This is actually in fact the Christian group at the USYD campus – called the ‘Evangelical Union’, which literally means ‘good news union’. And there are a whole bunch of us from the medical program, as well as dentistry, that meet up at this time each Tuesday. Here was a place where we could meet up in the busyness of the week and hang out, eat some food, share life, and chat about all sorts of things – from weighty matters of life and faith and meaning, to the challenges of our medical studies and future trajectory into the workplace. This block, we asked the question of ‘what does it mean to be a Christian in the healthcare world’?

Actually, if you are in the SMP or dental program, whether you are a Christian or not, religious or not, you are absolutely most welcome to join us over Tuesday lunchtimes. I would love to see you there, just hit me up! It is a really chill (and also safe) place to share your thoughts on things, to see what others think, and also to have all round thought-provoking conversations. I have conversations here that I would never otherwise have anywhere else.

A lovely stroll through Victoria Park, Friday 7:56 am

Another part of the weekly rhythm was a strange thing that happened each Friday – at 8 am. A few of us from the Christian group, including those in second year med, would meet up at Taste cafe, to hang out, chat, and also to pray for one another. I know 8 am is ridiculously early – but my freaking goodness, this gave me so much life. For some strange reason, this was something I really looked forwards to each week, and had no problem waking up for. There was nothing like waking up to the crisp cool morning air, watch the sun slowly rise on the train ride into uni, and start the day by recalibrating and meeting with others to pray – never failing to leave me energised, refreshed, and ready to jump into another day (and week ahead).

See, although many days I found myself disoriented and lonely, there was always little things throughout the weekly rhythm that would give me just that extra little bit of life, and the spark of joy that pushed me to keep on going. Sometimes, I look upon these wonderful blessings in my life and wonder how on earth I could even feel so terrible at times T____T was I just being ungrateful and discontent, and creating a big mess in my head? Or perhaps it was just the process of adjusting to a new stage of life?

In fact, there were even the littlest things outside of the normal rhythm that I found life-giving.

Calming tones at Manning after a long week

For example, one Friday afternoon, a friend from my clinical group was singing a really chill gig at the downstairs bar in the Manning building. For me, it had been one of those days when I was terribly depressed. Actually, it was a really long and difficult week. But, on this Friday afternoon, after everything was finally over, I went along to watch her sing – and it actually warmed my heart so much. The air was cool, the golden hour light streamed in through the Manning windows, the gentle strum of the acoustic guitar and the dulcet tones of her voice, the warming cheer of friends, the forgetting of the outside world, the peace brought about by the week sighing to an end.

When things are intense, I’ve learnt to hold onto the little things that make life a bit less alienating.

(5) Finishing

So, the last few weeks were finally upon us, and our first ever exam was looming over the horizon. The collective stress of the cohort was palpable – I could feel it in the air.

Our immune systems were probably compromised by all the stress

It was here when something really unexpected and interesting happened for me. On the Sunday evening of week 8, I found myself embarking on a little project which would take over my life for the next few days. See, earlier in the week, I ran a really short immunology crash course for my clinical group at the hospital – but there wasn’t nearly enough time to cover all the things I wanted to talk about. People said they found it helpful, so I thought “Hmmm… why don’t I just write a little document with everything I want to say? That way, people can look through it in their own time.” And so, on the Sunday evening, I started writing an immunology crash course, which set out to capture the story of the immune system and to illustrate the big picture – which is what I found the official immunology lectures were lacking in. I discovered I could use my laptop touch screen to draw things with my finger, and I think I got better and better at drawing as I went on. I spent many of my waking hours thinking about how to tell a story out of the immune system – and I had so much fun fleshing out the analogies and illustrations, got fairly carried away anthropomorphising the immune cells, and even wrote a Romeo and Juliet drama to illustrate the T-dependent B-cell response.

On Tuesday night of week 9, I finished producing this 34-page document, and posted it onto the medicine cohort Facebook page. You can find it here if you want to learn about immunology too!

Romeo and Juliet: a lymphocyte romance

It was a “bestseller” I suppose, and it was very, very warmly received by the community. People were so generous with their encouragement – many people messaged me with comments of thanks, and some even came up to me in class to share their appreciation. I was really glad that people were starting to understand immunology, which could be a bit difficult and complicated, and actually found it something enjoyable to learn about.

It felt really absurd. One week, I could sit unnoticeable at the back of a lecture theatre. The next week, it seemed like everyone knew who I was (and were giving their encouragement to me). And so, writing this immunology crash course wasn’t just helpful for the cohort, but it was actually helpful to me on an emotional level. See, the past week, I was feeling deeply depressed. When I was feeling very, very low, and had no “emotional coins” to give and had no way of connecting to others and loving them, the crash course gave me a way of connecting to the community and doing something positive even though it didn’t require me to interact with people and expend a lot of emotional energy. It was something I could do from the safety of my own room, and still be a part of the community which my soul yearned to be a part of. I think with a situation like this, it would be so easy to be prideful. So, I needed to fight hard to be sober – to remember that it was not me that was super good and saving the class, but it was God giving me the gifts and resources to be able to help others in this particular way.

For all this, I am so immensely grateful for people’s support and encouragement in a season which was fairly difficult. Yet, even though there was this high (which I rode for a little while), I still found myself sitting alone in lectures. HAHAHA. Look, I think it did become a little bit better and I wasn’t feeling as depressed. But I still found myself lacking those deeper, longer-lasting relationships with which I longed for. The paradox became more and more clear – that I was surrounded by people, even known by many people, but still I was feeling this sense of loneliness. Strange. What is wrong with me HAHA. Restless heart, why won’t you settle!?

This whole ordeal brought me to the final week of the block. Exam was approaching. Actually, I felt it was pretty chill – mainly because Anki is bae and I had learnt most things already. It really is like magic. But also, I think I discovered perhaps a part of the solution to the whole community issue – actually, it was relearning a lesson which I discovered when I started university: I needed to be intentional with relationships. I couldn’t expect them to “just happen”. I needed to actually say to someone “hey, let’s hang out or do something at X time.” I needed to make time for relationship, rather than expecting it to happen. Perhaps by the end of undergrad, things were so comfortable and so settled that everything just happened naturally, and I had taken this for granted. But if I remember to my first year of university… perhaps the experience wasn’t so dissimilar.

Anyway, the exam came, it was fine. Aolei was two seats in front of me. The exam started at 9:30. He left at 10:37. I thought “what! I’m only like halfway through the exam!” BUT it was fine we did the exam, and finally our first block of medicine was over. Now the exam is over, we could literally do whatever we wanted (right?), so a few of us… went to Luna Park to buy fairy floss (yes, for the sole purpose of buying fairy floss). But it was just really nice to, perhaps for the first time in a while, hang out with people even after class was over.

Danny asks attendant for directions to fairy floss at Luna Park after 1RSA1, c. 2019

Danny successful purchases fairy floss at Luna Park after 1RSA1, c. 2019

If you’ve read till here, thanks. I hope I haven’t made you bored with all my emotions. If Stuart Lane asked me where on Kolb’s theory of experiential learning I prefer to lie, you’ll probably find me right up the top of the perception continuum.

I’m looking forward to next block!