Medical Students Make the Worst Patients: The Tragicomedy of an MS1

Saturday, October 20, 2018

Medical Students Make the Worst Patients: The Tragicomedy of an MS1 is the third place winner of the Synapse Storytelling Contest's personal essay category. Comments from the Synapse managing editor and contest judge Sylvie Sturm: This story is just a breath of fresh air. With truly excellent writing skills, Mara weaves an entrancing story out of a hectic day, and reminds us all that when faced with adversity, sometimes all you can do is laugh.


Lying in an MRI machine, I start to laugh. The enclosed space resonates with the technician’s pleas to hold still and the aching expansion of my bruises, yet I can’t help giggling. If “humor is tragedy plus time,” then the past few days, on top of the last many months, has provided the proper incubation period for tragedy to become comedy. And so I laugh.

Doctors notoriously make the worst patients; but I argue medical students have them beat. First, we believe pain is standard: if we aren’t sleep-deprived and stressed and pushing our limits, we must be slacking. Second, we know just enough about medicine to be dangerous, but not enough to be effectual. Medical Student Syndrome is well documented; students commonly report symptoms that correspond to diseases they are learning in the classroom. We self-diagnose rare disorders while accepting actual damage as “rite of passage.”

Still rooted to my life as a professional runner, in January I decided to train for my first marathon. This new jump in distance provided a singular challenge and point of pride, even when fraying hip flexors prevented me from getting up out of a chair without using my arms, or when plantar fasciitis forced me to single-leg hop to the toilet in the morning, or when the little ache in my right shin became excruciating. During this time, I learned to diagnose innumerable diseases; but I refused to see how neatly I fit the epidemiological picture of an underweight, sleep-deprived, 100-miles-a-week runner with a stress fracture.

So I taped my shin and raced Bay-to-Breakers. Five days later I ran a 22-mile workout. When it hurt too much to run, I swam until I saw spots. I cried a lot, not in remorse for the 5 months of constant, relocating pain, but because my lacrimal ducts were insisting I be a patient instead of a stubborn medical student.

Three weeks before the marathon, I relentingly go to Student Health for the pain in my shin. Denied an x-ray referral for reasons I still don’t understand, I barge into radiology just before closing time and hand them my insurance card. (After imaging, I pound on the locked door until a janitor helps me retrieve said insurance card). I spend the next hour failing to open the CD-ROM on my Mac, and then running around campus in search of a compatible PC. Fortunately, an orthopaedic surgeon I have come to know is willing to read the results, which are negative for a fracture, and schedule me to see one of his colleagues in Sports Medicine.

Between appointments with the Orthopaedist and a same-day MRI, I’m meant to be shadowing a pediatrician at the off-campus hospital. Ignoring the stabbing throb in my shin, I’m making record time on my bike until a car door flings open and I hit asphalt. The call of doctoring is louder than my aches, however. I pedal away, then hurriedly scrub blood off my white coat before performing histories and physicals at the hospital.

En route to the MRI during rush hour, bike helmet firmly secured on my head, my insurance company calls. With one hand, I click through automated responses until a live representative begins soliloquizing about in-network radiological imaging options. I brake hard with my left hand as a Camry runs a stop sign, which sends me over the handlebars and back onto asphalt.

I extract a sizable piece of gravel from my elbow, retrieve my cracked phone, demand authorization from the stunned insurance representative still on the line, and arrive only 5 minutes late for my MRI. After an hour in a closet-sized waiting area (beside an individual I mentally diagnose with tuberculosis and a severe deficiency in respect for personal space), I begin to laugh. I laugh at the time I spent waiting; I laugh at the two cars that hit me today; I laugh at the trouble I had scheduling and obtaining and interpreting an x-ray. Most of all, I laugh at the absurdity of my cliché: it took me being stuck in an MRI machine to finally allow myself to be a patient. This is Life telling me to “sit down, and shut up,” because I am not taking care of myself.

Medical students make the worst patients because we want more than anything to be doctors; and doctors make terrible patients because they consider it impossible to provide care when they’re the ones who need it. Yet, with all the time I’ve spent in student health, radiology, the waiting room, and this machine, I could have helped countless patients. Not only does the stress fracture in my fibula physically hurt, it is also detracting from my ability to give to others.

Of all the patients I have encountered thus far, I have been the most memorable. My own tragicomedy has taught me that it is necessary to be a patient in order to be a provider. After only one year in the medical field, I forgot the importance of self-health; by serving health, I thought I was exempt from its laws. What a laughable notion.