S2E8: Confessions of a 3rd-Year Medical Student

Bushra: It's like as short as possible. Sometimes I just say "B."

Margaux: And then they don't know if you're saying "bae" or "bitch."

Bushra: I love that. That's the beauty of it.

Margaux: That is so funny.

Bushra: I'm glad we're all laughing because . . . so today we are talking about the interesting side of third year, the embarrassing, funny, confusing, frustrating moments that we have during our third year. And you know what? I'll start with a story.

Margaux: Love it.

Leen: Spill the tea, girl.

Bushra: Okay, you guys know I pride myself in learning people's names and remembering faces and all that stuff, right? I don't know if any of you all have ever spent time in a radiologist's waiting room.

Leen: The man cave of radiology. It's dark.

Bushra: It's pretty dark, yeah. So I met this doctor, I can't even remember his name right now to be completely honest but it was like for a split second and it was Monday of my second week and I was all like, "Hi. My name is Bushra. I'm a third year medical student doing this elective." He goes, "Hey, nice to meet you. Are you working with anyone in particular?" I was like, "No, but you know what? I would love to go to IR." IR is interventional radiology because that's where the action is and I could not stand another day being in that dark room.

So he's like, "Cool, cool. Let me show you where it is." But he ends up pawning me off to the fellow who takes me to the IR suite. Okay, I had the best day in IR. It was awesome. I got to do a lot of stuff. The next day I come back to that radiologist waiting room and I'm with another radiologist and he talks to me and he goes, "What was your name?" I'm like, "Bushra," and then I do my whole spiel. "My name is Bushra, third year medical student," and he looks at me like, "Yeah, I know who you are. We met yesterday." I was like, "Did we?" I was like, "I don't think we did because I . . ."

Harjit: No. You said that?

Bushra: I thought we had never met before. Yeah, because I couldn't recall his face or anything.

Margaux: Because it's dark in there.

Bushra: Yeah. Thank you, Margaux. Thank you for saying that. It was dark in there. I can't tell what's what. You know?

So he goes, "I met you yesterday. Remember I helped you get with IR?" and all this stuff. I'm like, "Oh, that's right." Then it's like complete awkward silence and thank god that it was dark because my face was probably so red. Then he goes over to me and he's like, "You know, if you want to make a good impression, you probably want to remember the people you meet."

Harjit: No he didn't.

Bushra: Yes he did.

Harjit: No he didn't.

Bushra: Yes he did. He was right. He was right. But, Margaux, it was dark.

Margaux: It was dark. You know, there's a joke, in peds we called it "going down to visit the shadow lords" because they live in the dark. And then when we went down there, there was this one radiologist who had those balance boards that you can stand and work your abs out or whatever. He was standing on one of those reading some images. They had artisanal juices in glass and it was just so extra.

Bushra: How bougie. Anyway, it's safe to say I'm not going into radiology though.

Margaux: Yeah, it's too dark.

Bushra: You guys, I was so embarrassed.

Harjit: You won't be able to recognize . . .

Bushra: I didn't want to interact with him the rest of the week because I was so embarrassed and he was just like . . . I think he was butt hurt that I didn't remember who he was but I was like, "Bruh, I'm sorry."

Margaux: It's all good, Bushra. It happens. There's a lot of things to be learned on third year. We're talking about embarrassing stories. I think something most third years can relate to is when you're on a new service and you're trying to learn the flow of things, and especially if it's like you're getting called to a crash or something emergent and you've got to run. I feel like medical students tend to be like little ducks following their resident and sometimes the resident just gets up and doesn't tell you, so you're in the habit of always keeping an eye on your resident and when they get up, you just go because they're not going to ask you.

Multiple times I've gotten up to follow a resident to the door of the bathroom and they turn around and they're like, "Dude, you don't have to come in with me."

Bushra: Oh my gosh. You have to play it off and be like, "Yeah, I was actually going this way."

Margaux: "Oh, I was going to the printer."

Bushra: "I know my way how to bounce around this hospital." I think the person who has the most embarrassing stories is Leen, so I want to hear her. We have a group chat. Start it from the beginning, girl. It's always blowing up.

Leen: I don't think I can remember the beginning. It's that bad.

Margaux: Just pick a good one.

Leen: I think by the end of internal medicine I became very literal. Especially when it comes to making plans, you've got to be super literal. If there's something wrong with the vitals, like fever, you're going to write, "fever," right?

So I go to see this patient. I think I'm super proud, you know? It's the end of IM, I'm doing really good in this pulmonology rotation. So I'm writing away and I'm like, okay, so I have the big problems, now what are the little problems that I guess are less dire problems that we're also working on? So I wrote, "Okay, patient has reduced bowel movements." I told the whole backstory why he has reduced bowel movements and what we should do for it.

Then my resident comes to me a little while later and he's like, "So I have some feedback for you." I was like, "Oh, yeah, I'd love feedback. What's up?" He's like, "So reduced bowel movements is called constipation." I was like, "Oh, yeah, that must have been my accent coming out," and he's like, "No. No, it wasn't." He was also from Saudi Arabia, so I thought he'd get it. He didn't. He was like, "No, that doesn't count." Yeah, that was great.

Margaux: When I was on gyn surgery, four hours after an operation you'd go and check on the patient to see how they were doing and their pain and if they were having bowel movements and what not. So I had had three surgeries that morning, I think, which you would think is not an unreasonable amount of patient information to manage but I walked into this patient's room and I was like, "Have you heard from your son? How's his backpacking trip in Yellowstone?" and her face went pale and she's like, "What do you mean my son's in Yellowstone?" She was panicking and I was like, "Oh my god, wrong patient."

Harjit: Oh my gosh. That's actually what I've been doing like 10 times.

Bushra: Yeah, how do you play that one off?

Margaux: I was just like, "How old is your son? I'm sorry, I'm thinking of a different patient." Then I learned don't ever assume unless you really know, so just ask, "How's your son?" because I think all of them had sons that day so that's a safe question. Or just, "How's your kid? Have you heard from them?"

Bushra: You try to go the extra mile and it just bites you in the butt.

Margaux: Her son was an 8-year-old and there was no way he was going to be in Yellowstone by himself. She was really worried temporarily.

Harjit: I'm chronically embarrassed so I can't tell the difference between what's an embarrassing moment and what's not. I'm the one who's making the awkward situations.

I was presenting . . . so we do rounding in internal medicine, which is basically like going in front of every patient's room and discussing that patient and then making up a plan right there so that their care is continually changed, right? Well, I was presenting a patient and I'm like, "Yeah, this patient has sepsis and they meet sepsis criteria because of X, Y, and Z." Then I said, "They have pneumonia and they're getting treated but they also had an X-ray of suspected pneumonia. We're not sure if it's pneumonia."

Then the attending stops me. He's like, "Did they have pneumonia or did they not have pneumonia?" I was like, "They have pneumonia." He's like, "Then what's suspected about it?" I was so embarrassed because you know sometimes you're just flustered in the moment. I was like, "Yeah, that's not what I meant to say," but I just took it as like he was like, "Yeah, you shouldn't say that." I was like, "Yeah, yeah, okay, okay."

But those are the things I do. I say stupid shit all the time. And then I remember one more. I think I shared this one with Bushra. It was my last day on my surgery rotation and the residents I worked with, they were tough but amazing in a good way because they challenge me but always ask questions after to make sure I learn everything in the end. So it was our last day and I was getting up. I just really wanted to tell them how appreciative I was.

They're saying "bye" and all that and then everything gets quiet and all of the sudden I get up and I'm like, "Can I give you a hug?" Then they look at each other and they're like, "Yeah, you can give us a hug." So then I gave them a hug, but it was so awkward because, oh my god, I think I made it so awkward.

Margaux: I think you did too.

Harjit: I think I did.

Bushra: That's not the story that I heard though.

Harjit: What was the story?

Bushra: From your co-med student that you were with, I think they were surprised in a good way that you asked for a hug and they said something along the lines of they hoped that internal medicine doesn't take away that aspect of how sweet you are away from you. I think it was awkward in your head. It was authentic. I like that you're unapologetically yourself.

Harjit: Yeah, that's maybe the thing.

Bushra: On the words and on your clerkships.

Harjit: I try to be because I think for a long time I was always worried about how I was looking or what people thought about me. But I just try to be who I am.

Bushra: I try to be very neutral. My facial expressions, they give me away a lot of the times so when I'm like, "Oh, that's awkward," or like, "I found that very offensive," that's written all over my face. So when I'm getting critiqued unfairly or something like that, I just try to keep a very neutral face.

Harjit: That must be very hard for you because you're actually . . . like literally you can tell from your face how you're feeling about something.

Bushra: I know. It's a problem. I think I try really hard. I don't know how successful I am at it because I can't see my own face.

Harjit: I personally think it's one of your strengths to let people know what's up. Yeah, because then people know, like because you let them know, "Oh, that wasn't okay," or, "I didn't like that." Not everyone agrees with you.

Bushra: Yeah, I just feel like I should save it for the end of a rotation when they've gotten to know me a little bit better and you have a little bit more respect, I guess, in that regard because you're no longer the newest person on a team. I think I get more honest about how I'm feeling the further I get along. But that's why the first couple weeks of a rotation suck for me. They suck because I feel like I'm like, "Bushra, girl, stay on your best behavior because you don't need none of this."

Margaux: You have to try so hard to not be yourself.

Bushra: "Just let it roll it off you. Roll it off you." It's hard. It's hard.

Leen: So I was on my 24-hour shift, overnight shift. It was the first time I ever stayed up for 24 hours straight in a hospital setting. That was freaking amazing. And I'm on the trauma team right now, the trauma surgery team. We respond to traumas that come in and we assess, make sure we stabilize the patient, assess them and then determine do they need to go to the OR, do they need to go to the floor, do they need to go to the ICU?

Last night was my first time and I was super excited. It was funny because the day before I emailed an ED doc and I said, "Can I do an overnight at the ED?" and she was like, "Well, we can try to work something out." But then I had my overnight and I didn't realize we'd be in the ED all night. So we left for a little bit to go assess a patient on the floor, and then I come back to the ED and there's security guards everywhere. The nurses are making a line, telling people where they're diverting triage and things like that and all the doors are locked. My card doesn't work and I'm like, "What is happening?"

Then I get an alert and it's saying there's a biohazard outbreak so the ED's on lockdown. And I just lost my shit. I got so excited.

Bushra: Leen loves the extreme situations.

Leen: I snuck into the ED and I was like, "What's the breakout? What are we breaking out from?" And the nurse was like, "You're insane." She was like, "Yeah, we're having a biohazard outbreak." I log into the Pulse system, it's kind of like the alert system for the whole hospital and it's like, "Low risk of possible Ebola exposure," and I went crazy. I got so excited. I was like, "Can I go see the Ebola patient?" and my resident was like, "No, you're crazy. You're going to get freaking Ebola. Sit down."

I was just so excited. I saw security guards everywhere and I was watching them do everything and everybody getting masked up. All the ED docs were kind of like, "Oh, great, here we go," and all the residents were like, "This sucks." But I was kind of in the background like foiling in excitement and everyone's like, "What is going on?"

Bushra: That sounds refreshing though.

Leen: I was so excited.

Bushra: Wide-eyed and bushy-tailed.

Leen: I go up to the sick queue and I go up to the nurses and there's a resident there. I'm like, "You guys, the ED's on lockdown from Ebola."

Harjit: It's like a show.

Leen: I remember all the nurses were like, "What?" And then the resident turns around and is like, "You're still going on about this?" It was the best thing I've ever experienced in my life. I was like, "I really want to go see the patient but nobody will let me."

Bushra: Did you eventually?

Leen: No.

Harjit: You never saw them?

Leen: I saw them moving the patient. They had the full on space suits on and I was like, "Yes."

Harjit: I saw that on "House" one time, the show.

Margaux: And "New Amsterdam" but you didn't watch it.

Bushra: You obviously didn't listen to our episode.

Harjit: No, I did listen to your episode.

Margaux: It was the best episode, I think. It was actually a really good one. Leen, did they actually have Ebola?

Leen: I don't know, actually. While I was on the trauma team last night I kind of accidentally fell asleep. I was studying. Somewhere along the studying I fell asleep and then I wake up so I have this crazy alarm for pages on my phone so that it really freaks me out and I wake up. So I get this, "Bzz, bzz," alarm. Anyway, I wake up to it and it's like, "Trauma in the ED," so I head down there. Problem was I was asleep, my contact stuck to my eye. I'm half groggy, I'm not even there and I just casually walk into the trauma and my resident's like, "Get to the position." I was like, "Yeah, okay."

So I walk over with one eye and I'm all droopy and the patient comes in and I'm just kind of sleepwalking through my physical exam. They're like, "Leen, shout it out." I'm like, "What?" He's like, "Oh, I'll shout it out for you." So lesson learned. Don't fall asleep on overnights.

Bushra: Do you sleep with your contacts on?

Leen: I accidentally slept.

Bushra: That's dangerous, girl.

Harjit: No, she told me she wasn't going to sleep because I had my 24-hour, same type of situation happened but in the opposite direction. I will tell you and you guys can make sense out of it. What happened was it was a Saturday and everyone's like, "Oh, on Saturdays, the weekends, so many traumas overnight." I was like, "Okay, that'll keep me awake. I'll be up and about." So I'm like, "I'm never going to sleep because when I wake up, I'm like a zombie. I'm a complete zombie."

So what happened was I was like, "Okay, I'm going to stay up." It was 10:30, basically we didn't have any other work to do. So I literally was sitting and watching, like, I watched a whole season of a show and then it was 6:00 the next morning and the resident comes in and the senior resident comes in and they're like, oh, they all look like they were well-rested. They took a long sleep.

Then they take a look at me and they're like, "How was your sleep?" I was like, "I didn't sleep." They're like, "What? Why didn't you sleep? You legit could have gotten eight hours of sleep. What are you doing?" I was like, "Yeah, I was afraid that I was going to wake up and be like not understanding what's going on and you would have seen that side of me," and then they all started laughing. They're like, "You're hilarious." It's like, "Okay."

Bushra: I would have knocked out. Peace out. You guys, I don't function well without sleep. Like less than six hours of sleep, I'm basically, like, incapacitated.

Harjit: But I'm worse with two hours and then waking up.

Leen: Yeah, I agree.

Margaux: When we do overnights in OB and peds, I just stayed up for 24 hours. So I woke up in the morning and then did my night shift and didn't sleep and then slept two or three hours that morning and then went back to nights. It's brutal.

Leen: That's brutal.

Margaux: I don't know, because I didn't want to switch.

Bushra: I guess you're going to go into orthopedic so get used to it.

Harjit: Okay, I shouldn't have shared this one, but I should. You guys know how I'm very, like, I'll tell you guys when I have to use the restroom all the time.

Margaux: All the time. It runs my life. Her bladder runs my life.

Harjit: I think my surgery residents noticed that. It was so embarrassing but I'm always like, "Oh, I have to use the restroom." They're like, "Okay. You don't have to announce it to the world." But I announce it to the world.

Margaux: Do you scrub out and go to the bathroom?

Harjit: No, I would never, not during surgery. Not during surgery but you know how . . .

Margaux: So you're capable of holding it.

Harjit: Yeah, I am, but it was so funny because I think they noticed and in the end I was just . . . just to make everything not awkward and super comfortable. I'm like, "Yeah, I'm just very open with myself." I think that's not the words I used.

Bushra: To soften the blow.

Harjit: I know. You guys know my entire GI system by now. I feel like I used the wrong words at the wrong time. Okay, I'm going to stop.

Margaux: That's fine. Speaking of the wrong words at the wrong time, I was presenting to my preceptor on a family med case and I said, "He was not protruding vomit or diarrhea," blah, blah, blah. Then the attending kind of looked at me like Bushra's looking at me now and he was like, "Wait, protruding?" I was like, "Oh, I meant projectile," and then I just kept talking because I was like, "Oh my god, that was so stupid." Then the other doctor who was in the room listening, she was like, "Good on you for just being confident and going with it."

Harjit: You guys, you know what's even funnier? When you see your classmates saying the most awkward things and you try to not to laugh but you're like, "That is hilarious."

Bushra: Yeah, I know. I'm supporting you right now by not laughing.

Harjit: Exactly. This is the way I support you.

Margaux: Yeah, there's a lot of power in saying something with confidence and just rolling with the punches.

Bushra: You know, they do say, "Fake it 'til you make it."

Margaux: Yep. I was hoping he wouldn't notice because I did notice in my head but I was like, "Just keep going. Just keep going."

Harjit: Oh my gosh. That happens all the time.

Leen: So I'm trying to think of some other stories that I have. I actually have a list of your stories, Margaux. I know, I keep track of these things because, honestly, this is what gets me through the day is just reading you guys' stories. Sometimes I just need a laugh.

You should tell about that one time where when you were delivering a baby.

Margaux: Yeah, so it was my first day on labor and delivery and as we have already talked about, your first day or week on any rotation and service is just like, you don't know what you're doing and who you're talking to or who you've already met and not met.

Leen: Shade. I'll let you continue though.

Margaux: So I . . . the gloves, I don't know if you've had an experience. Well, you'll all experience putting on sterile gloves. Kind of a difficult thing, especially by yourself. You know, you have to unfold the paper and very carefully put them on and then maybe 90% of the time your fingers don't go in the right holes.

Leen: Or you rip through the gloves. That seems to be my thing anymore, just go right through those gloves.

Margaux: So luckily most of the time you have someone helping you to hold the glove open so you can put your hand in it. But this time when a woman is 10 centimeters and crowning, no one's going to help you because you are not the priority at that moment. So here I am, my first delivery, I'm super excited. I'm fumbling to put on the sterile gown and then put on these gloves, very carefully lift them, and then I turn around . . .

Harjit: You're like, "I'm ready."

Margaux: I'm ready, but I have maybe two fingers flopping over. I'm holding my hands in the sterile position, which is out in front of you. I turn around, half of my fingers are flopped, and then I turn around and the attending's holding the baby already.

Harjit: I love that.

Margaux: It was like, "Dang it."

Bushra: You missed your first delivery.

Margaux: I know and it was supposed to be, like, med student baby because it's her second baby and those births tend to be a lot easier for the med students to deliver. And he's was just like, "Sorry. Get the next one."

Harjit: Babies are just being birthed all the time. It'll work out.

Margaux: Right? Yeah, and I did get to catch some babies later. I learned how to do the gloves. They let you take some home to practice. I really recommend doing that.

Harjit: You're going to have to teach me all that. I did surgery, but I did not once put gloves on myself.

Bushra: In deliveries it's a little different because it's usually you and the attending. That said, there's no, like, scrub tech or anything like that. It's not necessary. But gowning and gloving yourself is a good skill to have.

Margaux: Yes, but that's just, like, my quintessential first week of rotation is just me turning around, my gown is half off one shoulder, my gloves are half folded, three fingers in one hole.

Harjit: I wish I could see that image.

Margaux: I know. We needed a picture for Instagram. It's just the most funny. I was just laughing. Of course I would miss the baby.

Leen: On my first day in the OR, thank god I had the coolest scrub tech. He puts the gown on and I have my mask and then I put my hands . . . he has the sterile gloves, right? Okay, so I don't know. I twisted my fingers and put the glove in, but I didn't realize I did that and so he's sitting there looking at every finger. He's like, "I don't know if this glove's deformed." I was like, "Man, the glove, this one got past the machines. It wasn't made well." He's like, "Oh, your fingers are twisted." I'm like, "Oh."

Then after the procedure he was like, "So the way you're going to do it, you've just got to rip it off," and I'm sitting there and it's not ripping off."

Harjit: Oh my gosh. That's so hard.

Leen: Usually, okay, if it takes five minutes for the student to get it off, that's fine. It's like, they're a med student. But it took me a good, like, half hour with the scrub tech.

Bushra: Someone didn't just eventually have mercy on you and take it off?

Leen: He's like, "Okay, okay, so let's try this technique." He taught me, like, five techniques, by the way, throughout this entire process. It was so embarrassing. He's like, "Put your elbow in the sleeves and then rip it off." I was like, "Okay, I'm ready."

Margaux: I totally know that. You're all ready and then you just pull as hard as you can to rip and then it gets stuck around your hands.

Leen: He pulled me aside. He's like, "It's okay. You're learning. I totally understand that this was all embarrassing."

Margaux: That's nice of him.

Leen: There's a procedure coming into the OR and I'm still there ripping my gown off. It was so embarrassing, you guys.

Bushra: I hate being rushed, you guys.

Harjit: Oh my gosh. It takes longer for you to do something.

Bushra: And obviously you make more mistakes too. You end up missing a delivery or the opportunity to scrub in. More often than I'm comfortable with I feel like I'm being rushed. "Oh, your patient's already here." "What patient? I didn't know I had a patient" You're furiously looking through the electronic medical record trying to figure out who this person is and why they're here. I like to be calm, cool, and collected in front of the patient.

Leen: Even if it's fast-paced, as long as you're aware, that's fine.

Bushra: I'm just like, at this point, I should just expect to . . .

Leen: Or the worst is just when like, okay, you know a patient is coming in, you only have five minutes to go through the record, all the residents are going through the record. So we go to see the patient right before the residents are giving a run down of the patient and it turns out the stuff you read, you don't know if you read the right record at all because they'll just tell you the most random . . . you're like, "I didn't read they had heart failure. Where did you get that from?" That's the worst. Then you just feel like you don't know what you're doing.

Bushra: They always know something you don't know. They always know a lab value that you didn't see in the fricking EMR. They always know that little important bit of information that you just don't know and you just go, "Oh, okay. I'll have to look that up." I've been saying that a lot lately and I'm not going to argue with whoever your superior is, whether it's a resident or an attending because sometimes it could have just been a new lab value that just came in and you weren't able to see it and it's not your fault, necessarily. But you've got to stop being butt hurt about these small little things because you don't want to annoy your superiors.

Leen: It's not worth it. You don't have the time to be butt hurt about the small things.

Margaux: You learn tips and tricks along the way about navigating the different EMRs.

Bushra: Yo, I appreciate those residents that just take mercy on you. They look at you and they're like, "Look at this hot mess. Let me help you out." That happened to me my first day at the VA. This EMR that they use that's, like, literally so outdated, so outdated, and this sweet resident came up to me and she saw the frustration in my face and she's like, "Are you okay? Do you need some help, how to navigate?" I was like, "Yes. I do need help. Yes, yes, yes, I do. I don't know anything about this."

Anything that you would want to find is not ideally located. It just doesn't make any sense, so she spent some time and showed me tips and tricks and made my life the rest of the two weeks a lot easier than it would have been. Shout out to those residents. You all are the real MVP.

Margaux: Gold stars. I love the resident who showed me the copy forward function in Epic. In OB, while women are in labor and delivery, you end up doing a lot of repetitive notes as you're monitoring them through labor. So this whole first week, again, I was typing out the whole note over and over and over again, and then by Friday this resident, he's like, "You know, there's a button that just says 'copy forward' which copies the note that you had written prior and then turns it into a new note and then you can just edit it from there because you're making very little changes." Yeah, it saved so much time.

Bushra: I didn't know that. You're going to have to show me that.

Margaux: Yeah, I'll show you.

Harjit: You're going to have to show me too.

Margaux: Those little gems that make your life so much easier.

Harjit: Yeah, and I think that a lot of those people actually help make those embarrassing moments a little bit easier because they're like, "We've been there. We've done that." I've actually had a lot of residents say that to me, like, "Oh, I used to do that too. Don't worry, you're not the only one."

Leen: I think the residents who came from the same background as me and shared the same passions as me really helped me the most. They completely understood where I wanted to go and what I wanted to do and that this little hot mess is eventually going to be a doctor. One day. And they really supported that, so shout out to them.

Bushra: Yeah, we appreciate you all. Well, everyone, thanks for listening to us and our stories as we stumble gracefully through medical school. Make sure to give us a shout out on Instagram and Twitter @bundleofhers for both of them, right?

Leen: Yeah. You've got it, dude.

Bushra: And if you guys have funny stories that you want to share with us, feel free to reach out on our various social media platforms. And until next time, bye-bye.

Margaux: Bye-bye.

Bushra: Yeah, I've been here.

Harjit: Dude, look at you.