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“Sir,” I said, “You’re not going to like what I have to do next,” I told my 79-year-old patient with belly pain.

“What’s that?” he said.

“Anytime there’s abdominal pain,” I explained, “We’re supposed to do a rectal exam.”

“You’re not going to like it either,” he replied.

“That’s true,” I told him. “But the good news for you is that I have slender fingers.” And so begins the third year of medical school.

The first two years of medical school are mostly book learning, studying all of the time, and learning the theory of medicine. Third year is where it gets real. I have to do a variety of clerkships (Surgery, internal medicine, pediatrics, psychiatry, neurology, family medicine, and obstetrics and gynecology.) This is where I try to apply what I’ve learned over the past two years. Most of the time, I have no idea what is going on, but sometimes, I am actually useful. I mean, the surgeons need someone to cut the knot right? And retract skin back during surgery, I can do that!

For instance, I did trauma last weekend at a level 1 trauma center. There, I dressed up in a mask and gown and responded to a variety of traumas. Mostly car accidents and motorcycle accidents (Lesson 1: Wear your seatbelt/helmet/leather). There was a little girl who was hit by a car and a man who got into an accident with farm equipment that broke both arms. It’s crazy busy and stressful, but I helped by cutting off clothes and turning the patient around. Sometimes, you can just help by offering an extra hand or providing some comfort to the family.

I’ve been in the clinic for a whopping week now, and I’m learning a ton. I’ve looked at more butts this past week than anytime in the rest of my life. Also, I helped change the diaper of a WWII veteran, so yay? I’ve had some fantastic patients and some grouchy ones. The trauma ones were unsurprisingly irritable, but I think I would be too if I was in a major car accident, helicoptered God-knows-where, and then surrounded by strange people in sterile gowns and masks who were cutting off my clothes. Once the narcotics kick in, they tended to calm down.

I haven’t figured out what I want to do, but I’m leaning against surgery. The hours are neverending and being in the OR is very stressful. You can’t touch anything and the nurses watch you in case you break the sterile field, which is a huge no-no. One of my teammates gave himself a needle stick today and had to go to the OR. Nurses are often annoyed at med students, and that only confirmed their annoyance.

Tomorrow there’s a hernia repair. Gotta read up and study for that. Exciting times.