FEATURE
THE JIGSAW PUZZLE of Medicine
Charles Shofner
It’s hubris how, after reflecting on your
first year of medical school, you believe
you learned so much about the world of
medicine. From the countless late nights
tracing metabolic pathways, the hypothetical
eternity spent in the anatomy lab, or the Through this experience what I gained to be even more valu-
able, analogous to a puzzle’s centerpiece if you will, was the clinical
knowledge. Participating specifically in the hospitalist externship,
I essentially was given a trial run on the pediatric clerkship that
awaits me third year. I learned how to round on patients, how to
be involved in patient care as a medical student (phone calls can
multiple standardized patient encounters,
you look back and start to wonder if you are
ready for the clinical world of medicine. Ironically, reality quickly
greets you like a long-lost friend and shares with you a secret: that
the actual world of medicine is nothing like first year lectures, that
the knowledge you gained is but a few pieces of a thousand-piece
jigsaw puzzle. offer lots of information as it turns out), and how to work in a large
team composed of residents, nurse clinicians and attendings. This
is the type of knowledge that textbooks and classroom lectures will
never be able to capture. This is the type of knowledge which not
only makes me a better student moving forward but will make me
a better physician.
However, upon reflecting on this externship, I have realized
that this opportunity was exactly what I hoped and envisioned: an
academic enriching, career-guiding motivator for my future. I feel
moving forward that by participating in the pediatric externship, I
have gained additional pieces to the puzzle that is medicine: pieces
to which very few of my fellow classmates have access.
One of these pieces is academic knowledge. If you were to ask
me four weeks ago, what are the various methods physicians employ
to reverse hyperkalemia, I would’ve stared back at you blankly and
offered the helpful solution “I don’t know.” Trust me, because it
happened during the externship. However, because of the past four
weeks I can now give you a list, such as administering insulin with
glucose or beta-2 agonists like albuterol. The amount of scientific
medical knowledge I have gained is unparalleled and directly goes
towards enriching me as a student entering second year. When we
cover medical conditions - from status asthmaticus exacerbations
to Kawasaki Disease - I will be a better student because I have
had the opportunity to interact with patients who live with these
diagnoses. The words on the lecture slides will be replaced with
memories of people.
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LOUISVILLE MEDICINE
Perhaps the greatest takeaway was the personal discovery that
this opportunity provided. I discovered that the world of pediatrics
is a world where holistic medicine takes center stage. It is a world
where every day you are exposed to patient resiliency and teamwork
comradery. I am not naïve in saying every day is “rainbows and
butterflies,” there were some days when parents wanted to forego
care for their child battling cancer, and others when social work
and child protective services were called to intervene. Yet, the joy
of seeing a child return to their normal, playful self over the course
of their hospital stay and hearing them say “Bye” ten times over
as you walk out of the room fills you with bliss. It’s moments like
this that draw people, including myself, to pediatrics. Wherever I
end up in medicine, this externship showed me that working with
children must be incorporated.
Ultimately this externship reminded me that it is okay that I do
not currently have all the pieces to complete the puzzle of medicine.
Nonetheless, it did give me a glimpse at the final jigsaw masterpiece.
It revealed an image that excites me for the future and motivates
me to continue pursuing the joy of medicine.
Charles Shofner is a second year medical student at UofL School of
Medicine.