Chairs Missing by Joe, resident at the New England College of Optometry

8Oct/13Off

White Coat 2: The Legend of Curly’s Gold

Joe Rob

In the last few weeks, I've been settling into a groove over at the VA. The part of the residency where we were treated like a "super senior," basically like a student intern but with a little more trust,  is essentially over.  We are hence moving on to bigger tasks and more of a supervisory role to the students. And I've even been able to precept a few more student exams recently.  At the same time, more and more I've been feeling confident in my ability to manage difficult patients on my own (difficult patient meaning they have many ongoing disease processes effecting the eyes, not that they are personally difficult). I've found myself less stressed out and I've actually been able to see patients and do my charting in a timely matter such that most days I'm able to leave on time. The ripple effect of this means that I have had more spare time to read articles or books on interesting topics.  I've had a few patients that have had somewhat rare retinal diseases in the last few weeks, radiation retinopathy, interferon retinopathy (to name a few), and I've even seen a couple of things that we weren't exactly sure what it was just yet (pending referral). Some of these cases are interesting enough that I may end up basing one of my end-of-year research projects on one.  It  feels like it's all coming together.

So this leads into some thoughts about my other job through NECO, as a tutor and Preclinic monitor. As resident monitor, we mostly help the second year students as they learn the more difficult techniques associated with a basic eye exam, starting with biomicroscopic exams of the front of the eye. In a few weeks, they will start things that actually come in contact with the eye such as checking pressure, and then beyond to dilated exams of the back of the eye.  So just as things are coming together for me into a whole "I am confident doctor" package, I am re-hashing in bits and pieces of what was one of the more stressful times as a student. At times I feel unsure if I am able to explain things to the students in a way they can understand. Things that are so natural to me are for them so forced and unsteady. I can certainly remember what it was like and sympathize but I am unsure if I am actually conveying concepts and teaching effectively. I have gained even greater appreciation for the professors who taught me so seamlessly. I have much to learn about teaching, I think.

Being there to see the students struggle through what is old hat for me, along with the fact that my brother is currently a second year as well, means I've been reliving second year. At times it is almost like watching an also ran sequel to some old summer blockbuster (alternate title to this post White Coat 2 : Electric Boogaloo). I've been talking to my brother about his various 6 or 7 mid-terms he's studying for and how he's squeezed to find time in there to practice techniques as well.  He is understandably stressed and it makes me anxious just to talk to him about it. I really forgot what it was like. At times, over the last few months I found myself missing my friends and Boston and the worry-free student life, but more and more I realize that I am being nostalgic for a time that never really existed.  I could never go back and relive those times, and sometimes I'm not entirely sure how I survived the workload.

And so last weekend my wife and I attended my brother's white coat ceremony, which stood out when I was a second year as a monumental achievement.  I can still remember being up there like it was yesterday.  The intimacy of the small auditorium, the sound of your name being called while everyone cheered as they put on your crisp white coat. For a few brief moments you really felt very special. Now you could start to see real patients and were thus one step closer to actually being an eye doctor. You forgot all the stress of classwork.  It was almost like graduation from high school all over again, taking pictures with all your family and pals, and partying afterwards.  It was pretty much a defining experience of being an optometry student. So it was very strange to be on the other side of the stage, cheering on my brother from the audience. The cynical, knee jerk reaction as we waited for them to file into the hall was to think why so much hoopla for such a seemingly small achievement? And true, in the big scheme of things, they really have just scratched the surface. They haven't yet faced patient care with full exams or passing any second or third year classes, or even thought about studying for boards. But then the cynicism faded as I remembered again what it was like. And as I recognized many of the faces of students I have been working with in Preclinic, I felt happy for them. Knowing how tough the road is just to get the white coat is achievement enough for now. And I have personally witnessed many of them work very hard to this point. Hopefully they savored the moment as they gear up for bigger challenges to come. And hopefully I can play a small part helping them in the weeks ahead.

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