this story originally appeared in the philippine daily inquirer on August 30, 2012.
I was sitting in class, happy with the Wi-Fi in that classroom, when I opened this e-mail: “Congratulations. You have been accepted to the Harvard Medical School Exchange Clerkship Program.”
What? I was actually accepted for subinternship at Harvard Med? I could hardly contain myself and wanted to squeal in excitement. I reminded myself I was in class and I had to keep this a secret.
See, this was a moment of truth for me. As an incoming fourth year student at the University of the Philippines College of Medicine, I had to take an off-campus elective during my summer break and move out of my comfort zone by taking it in a hospital abroad. Little did I know I would be going to Harvard Med.
I loved visiting Ivy League campuses when my family and I traveled to the United States. But to be an actual student there was a different story altogether, more so because I chose a rigorous elective. I was to be part of the surgical team in emergency care at Massachusetts General Hospital, one of the best hospitals in the United States and the chief affiliated hospital of Harvard Med.
The daunting part was the schedule: I was to be awake and on call for 24 hours at the emergency department (ED) every other day for a whole month. It’s basically like a real-life “Grey’s Anatomy,” except that I’m a medical student. Meredith Grey and her friends are interns (first year residents in the US system) in the series. But, on the other hand, I was a subintern—not yet an intern, but expected to step up to the next level.
Definitely, absolutely, positively scary. Was I excited? Hell, yes.
I flew to Boston weeks later. The first time I entered Mass Gen (where a few of the world’s medical breakthroughs were discovered—anesthesia, for instance), I was awestruck. I was in a very significant place in medical history. This was going to be my working and learning environment for the next four weeks. I was so excited and determined to succeed, just like the very driven Cristina Yang in “Grey’s Anatomy.”
When my white coat and scrubs were given to me, I loved the fact that the scrubs were powder-blue, exactly the same shade of the scrubs in the series.
I felt every bit like an aspiring surgeon. The pockets of my white coat were bulging with reference booklets, energy bars, and writing materials; my watch and beeper were indispensable items; the drawstrings of my scrub pants even had sutures attached in case I felt the need to practice my surgical knots!
All these were put to good use. On my first day, I was thrown into a full-blown 24-hour shift. I saw patients right away, took their history and examined them, and thought of a plan for them. On top of keeping up with the patients rushed into the ED who needed a surgical consult, I learned to write preliminary notes for each of my patients.
The workload was challenging, especially in the most ungodly hours. But the important thing to remember was, what needed to be done had to be done.
At about 7 a.m., my last hour of duty, I followed my residents to what we called the sign-off rounds, where those who were on call discussed the significant cases of the past 24 hours. How interesting it was to listen to discussions on how a patient was managed and the alternative ways of managing the case better. I loved the open-minded discourse. I loved how, as a young resident, one was allowed to decide what was best for the patient. But, at the same time, there were attending physicians challenging one’s decisions, making sure one was learning and thinking critically, so that one would become better at clinical judgment for the sake of one’s patients.
It was just my first day, and I loved what I was doing and where I was.
The next days and weeks became more challenging, though. I was given more responsibility for my patients—not just the usual history, physical examination, and assessment, but surgical procedures and trauma protocol. The first time I sutured a man’s lacerated face was exhilarating. At 2 a.m. I was gung-ho and alert, not from caffeine, but from the adrenaline of being given the opportunity to sew up a face.
The first time I did the FAST (focused assessment sonography for trauma)—an imaging exam that uses ultrasound to detect bleeding in specific spaces in the body—I literally panicked. I sure as hell did not know how to properly read an ultrasound, let alone find blood that wasn’t supposed to be there. My resident patiently guided me and let me do the FAST on different patients countless times; she let me take responsibility for what I saw and my interpretation of it. I stopped being afraid and uncertain, and began performing the exam without too much self-consciousness.
The day came when I started seeing what I was supposed to see, and I finally got the technique. The greatest reward was confidently yelling the results to my team and to other teams, given the stressful emergency setting.
Aside from getting to do things I’ve never done before, I learned a lot about interacting with patients. I appreciated the US system of being pleasant, accommodating, and very, very patient with patients, no matter how difficult or disagreeable they seemed.
I was fascinated with my patients’ cases. These fueled my desire to learn and stimulated me in a way I’d never been before. I discovered that when one got curious and interested, it became less intimidating to approach residents and interns to ask about a particular case. This initiative led me to crazy-beautiful experiences I would never have had otherwise.
My favorite is the one where a man came in from a car crash bleeding inside his head. I got to follow his case closely—from the trauma bay resuscitation to the CT scan lab to the actual brain surgery. Seeing such a delicate, dangerous, and daring surgery is one of my best memories in Mass Gen.
All in all, my experience as a surgical subintern in Mass Gen was very precious, gruelling, and life-changing. I was happy to be treated like a regular Harvard Med student, regardless of the fact that I was a visiting student and I was as yet unfamiliar with the US system.
I was allowed to be independent yet I was also integrated in the system and the hierarchical order. Despite my inexperience, I felt part of the surgical team, and my input was always valued by those above me. My performance was always given due feedback, and this pushed me to grow and become much better.
I have so much fabulous things to say about my training in Mass Gen and Harvard Med. But more than that, I would like to say thank you to the attending residents, nurses, and physician assistants who were all a part of my stay there. The biggest thanks would be to God who blessed me with this training opportunity, and to my family and loved ones, who have given me unconditional support to go for it.
My dream of becoming a surgeon was fueled when I started watching “Grey’s Anatomy” a few years ago. My life-changing experience in Mass Gen and Harvard Med has given me the certainty I need. Yes, surgery is for me. Bring it on, baby.