Thank you Fourth Year!

Dear Amazing Fourth Year,

Thank you. Thank you for sitting me down and telling me what I need to know... what I need to know today, for this semester, for this year, and for this summer. And thank you for telling me that I don't need to worry about anything beyond that time frame right now.

Thank you for telling me that it's just safer to say "52 year old woman" rather than just "52 year old female" because an attending might ask, "Female person? Female dog?"

Thank you for offering to let me practice a head-to-toe physical exam on you (or a friend you beg to help us) so I can be ready for my practical exam in early December. I really can't do any of the systems without looking at the sheet (Heart rate then respiratory rate? The other way around? When do I listen to the lungs? When is the patient laying down, but elevated 30 degrees? What is jugular venous pressure and where do I look to see that it's normal?.... ya got me!)

Thank you for setting up times for me to go to the hospital and round with the attendings, residents and 4th years. I think it will be really helpful to see it all in action! And I can't imagine a better motivator than wearing my white coat in front of real live patients :)

Most of all, thank you for going through med school, even though none of your family went through it and you didn't know what to do or what to expect, because by watching and listening to you - I KNOW that it will all come together! Instead of having a list or 2 or 3 differentials or possible causes of the illness, I'll be able to list off 15 things when an attending or resident asks me for a differential diagnosis. And I'll be able to defend why each one might be the cause... and I'll know which tests, observations or questions about the patient's history would eliminate things from my list.

It's ok to be at the "one day at a time" phase right now. And I am suddenly really excited to learn this stuff about how cells work! I need to know how ion channels in cell membranes work... so I can understand how they make muscles contract... because certain drugs will alter these ion channels to increase heart rate or decrease heart rate. And I need to know that - because eventually I'll see a patient who is having a problem with her heart and I'll have to give her a drug. And I better know what drug will help her because then she might give me a hug and say thank you. And that will be a good day.

So thank you.

Sincerely,
Melissa