Power of a White Coat

My ER preceptorship was this morning.  I was incredibly nervous at first, getting dressed in my brand new scrubs (didn't want to smell like a cadaver), putting on my white coat--I felt like an imposter.  Surely, I thought, someone will see through this.  Someone will look at me and realize that I am nowhere near qualified enough to wear this garb and will point out my inadequacy.  I do not feel like a doctor yet.  I don't even feel like a medical student.  

Yet there is some strange, inherent power to the white coat.  It's only hip-length, which signifies to those in the know that I am junior, inexperienced, unqualified...but to those not in the know the coat means power, authority, knowledge--the ability to end suffering and mediate treatment and maybe even hand out a free drug score if you really know how to work the system.  I walked into the elevator from the parking garage on my way in today, and the two ladies riding with me looked up to me and asked where the pedway was.  It was such a simple question, but from the way they looked at me, you could tell that they would have accepted just about anything I said as gospel truth--because I was the one in the coat.  I sheepishly admitted that I did not know, I hadn't been in the hospital much. 

When I actually got to the ER where I was spending the day and met up with the doctors I would be shadowing, we had a really fun time.  It was much different than the experiences I had had previously, when I was in high school or undergrad.  Then, I was clearly a nuisance, someone getting in the way.  Now, I have the coat--doctors called for me, nurses gave up their chairs, patients accepted my presence without question and even encouraged me to ask questions or congratulated me on being simply what I was--the "student doctor."  Truth be known I know about as little about their disease or how to diagnose and treat it as they do.  But that's why I'm there.  To watch, and listen, and learn about their disease and treatment and so much more.  It was fascinating to see how quickly the physicians I shadowed could run through a history, making sure to ask the questions that were most pertinent to the problem at hand and coming up with answers so quickly that I had not even processed the little applicable information I knew by the time they were on their way back with a prescription.  I saw a sinus infection (five minutes from the time we walked in to the time the person was discharged), a man with a large boil (possibly from a MRSA infection) that had to be lanced and packed with gauze, and a woman with such trouble breathing that I just wanted to force air into her myself.  I left before she was well--she probably had to be intubated and kept overnight.  One woman was diagnosed just last night with an inoperable brain tumor and had to be brought back in because she was having more seizures.  She refused to stay and be treated.  And at least three people that came in while I was present were "repeat offenders," in and out of the department with so-called chronic pain, looking for drugs.  If nothing else, it was fascinating to see the patient-doctor dynamic in those situations, to see how all involved handled it when the doctor refused to give a patient narcotics.  

I was worried when I arrived today that I would be bored, like I used to be when I shadowed in an ER as an undergrad.  In reality, time flew by pretty quickly (and probably would've gone faster had I been filling out all the paperwork that the doctors were doing).  The nice thing was to see what the actual doctors do all day long, rather than nurses or techs or orderlies or a combination thereof.  The even nicer thing was that it is definitely something I can see myself doing every day.