On top of the world

As second year med students, we are paired up with a doctor who is supposed to teach us how to properly interview and do a physical exam on a real patient. In addition they should go over how to come up with a differential and start to think of what to do for the patient. My "preceptor", as they were called, was an ED doc. She did a great job of just throwing me into a patients room and letting me do my thing. She also did a great job of making the ED a classroom. We'd pass by a random x ray left up and she'd have me read it. A resident would present a case and before they could get to their assessment, she'd have me go through it. I learned a lot.



By the end of my second year I remember feeling on top of the world. I was almost done with a whole year of path---I was taught the most common diseases as well as some of the most random ones. I knew my shit.



I went down to the ED one day to work with my preceptor. There was an emergent case of giant man with kidney failure and leg weakness. She handed me the EKG and I had no idea what was going on with the squiggly lines but she was giving tons of orders, so I knew it wasn't good. He ended up having hyperkalemia and the EKG showed a prolonged PR and peaked T waves (the classic sign for hyperkalemia). She went over the treatment (C BIG K is the mnemonic) and what to do as I furiously scribbled it down in a little note book trying to hide my shock. I remember looking up from my notebook and asking "Dr. C--when am I supposed to be learning this stuff? I mean I am almost done with my second year and I've never heard any of this." She sorta chuckled and said, "You didn't know this already??! Hahaha, just kidding. No worries--you will."



Looking back on that instance and then where I am now is astounding. The amount we learned in this one year is incredible. But again, I feel on top of the world. But the main difference is, I am starting to worry---this time around, I know there is STILL so much to learn and I'm worried there may not be enough time before I'm given real responsibility.