Editor’s note: This is the first in a series of real-life essays written by physicians for entry into medical school and into residency. We hope that by sharing these, those who are not physicians will have the opportunity to see the “why” and know a piece of our hearts. We also hope that those who are physicians will be inspired and touched and helped to remember why we do what we do- the meaning behind our work.  Naturally, copying any portion of these essays will constitute plagiarism.

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Calm in Chaos

My first patient as a paramedic was a suicide.  He was a twenty-three year old jumper. When I showed up, CPR was in progress, and a physician on the scene had attempted a cricothyrotomy.  As the firemen moved the patient to the ambulance, the airway catheter dislodged, and I was left alone with a patient in cardiac arrest without an airway.  Immediately I considered my options, realized that the patient’s face was too mangled to attempt intubation, and knew what I had to do. Not sparing a moment for panic, I slid my index finger into his neck, located the hole in the cricothyroid membrane, and stuck my finger in it so as to not lose my place.  I then replaced my finger with an ET tube, secured it, and continued CPR with good ventilations all the way to the hospital.

I had begun volunteering as an EMT with the Bethesda-Chevy Chase Rescue Squad about four years before that incident primarily to meet new people and help out in my new community. 

At school, I was studying foreign languages, yet as I gained experience on the ambulance, I found that I really enjoyed patient care.  I began developing a serious interest in medicine. I found helping others satisfying. My patients trusted my judgment, and interns were seeking out time with me for training. It dawned on me that my tendency to be very calm and organized during stressful situations is not the norm.  Everyone–patients, families, physicians and other volunteers–began telling me I should seriously consider medical school. I began to agree, and I changed my major to chemistry, a subject that had always fascinated me.

I’ve always been incredibly curious, a fan of puzzles, mechanically inclined.

I’m also intuitive. I’m the one who notices when someone is sad or anxious, even if nobody else does. The more I was exposed to medicine, the more I realized that these particular traits came into play.  Patients are like puzzles, both physically and emotionally complex. Although my role as a medic is primarily to stabilize and transport, I’m always inclined to look further. My tendencies to pay a lot of attention to detail and be keenly attuned to all my senses improve my patient assessments.  Does the unconscious patient smell of alcohol? Are their fingertips dotted with evidence of life with diabetes? What do their pupils look like? Have they lost continence? Bitten their tongue? Injured their head? While assessing a patient, my mental gears constantly turn, and I realized that’s really important for me.  Time passed, and suddenly one day I realized that I’d kept the job I did for free longer than most paying jobs I’d ever had.  

That realization struck a chord with me.  I decided it would behoove me to investigate if working in a hospital setting would be as interesting to me as the pre-hospital setting, so I sought out experience to help me decide.  People at the hospital echoed the sentiments of the others and urged me to consider medical school, but the economic commitment intimidated me. I wanted to be positive this was what I wanted before making the investment.  Currently I’m working as an ER Technician, despite having completed my Master’s degree. It’s not a job that fattens the wallet, but I enjoy it. I make a lot of beds and change diapers and catheters, and start IVs and do about a million EKGs everyday, but I don’t really mind it all because most patients are nice and sometimes a dry diaper and a warm blanket really is the best part of their time in the ER.  The department I work in is small, so I’ve been getting valuable hands-on experience. I get to assist in a variety of procedures, look at hundreds of EKGs, X-rays, and CTs, help in countless codes, and interact with patients of all ages with a variety of histories, complaints and demeanors. All the doctors, PAs, and nurses are generous about answering my innumerable questions and sharing interesting cases with me.

I’ve spent significant time trying on medicine and observing the roles of different types of healthcare providers.  I’m confident that the role of physician most suits me.

I like to be the accountable decision maker.

As a medic I take that responsibility very seriously and seize every opportunity I can to increase my clinical competency.  Being a doctor would give me the autonomy I want to enact appropriate treatment based on my assessment findings, rather than waiting on someone else to make a critical decision. I’m privileged to work with all different types of doctors, with all different styles, and I’m learning why the good ones are good.  I’m not sure what type of medicine I’d practice, but whatever I choose, I’ll do my best to stay on the cutting edge of my field.

I’ll try to remember to never lose compassion, even when it’s a challenge, because compassion and empathy are an important part of responsible decision-making.

I also hope to one day be able to volunteer again by working with disaster relief or public health organizations.  Regardless of where I end up, the experiences I’ve gained as a paramedic and an ER tech have made me absolutely certain that medicine is for me.