On the final week (or Graduation: a post-mortem)

What a wild week. I’ll proceed chronologically: Capstone TIPS, ACLS, then Graduation.


Capstone TIPS

A required 2day course for graduating medical students, a sort of intern year boot camp. Monday and Tuesday went in a blur as a result: Mackenzi attended the first day, Monday, while I stayed in the hotel with Joonsu. The course director and dean of students both approved this plan, since we had trouble finding adequate childcare.

That afternoon, we both needed to attend a financial aide session. To assist us with childcare, two SPs volunteered to watch over our son in the hotel while we learned all about student loan repayments.

I attended the second day, Tuesday, while Mackenzi stayed at the hotel. Again, that afternoon we both needed to attend a mandatory session. This time, a graduation rehearsal for the entire class. The entire 2019 Class together, for a penultimate time. I recall the vibe as ‘strong’: so many catch-ups and side conversations all over the place. Seeing a familiar face prompted a smile and wave, sometimes a quick conversation. Honestly, by the end of the session Mackenzi and I felt exhausted and did our best to leave ahead of the crowd. This will be a theme for the remainder of the week.


ACLS

Advanced Cardiac Life Support: meaning how do you run a code in the hospital? When a patient’s heart stops, what do you do?

BLS, or Basic Life Support, is a review of CPR, or chest compressions, and dislodging food from a victim of choking.

ACLS covers what medications you administer when chest compressions and a quick shock aren’t enough. What do you do in the tenth minute of chest compressions?

The instructor for the course seemed quite passionate for the material: a physician-educator that worked with us extensively during the first two years of medical school. In retrospect, I’m incredibly grateful that he taught the course. He knew that we all stand on the precipice of intern year.

In a few short weeks, we may be the ones to run a code while assisted by nurses, techs, and medical students. And they would all look to us to take command of the situation because of those two letters by our name: MD.

The first day consisted mostly of didactic lectures. Slow and uneventful. I found my attention drifting toward the end of the day and guilt would wash over me every time: I should attend to this information as it may honestly help me one day soon. The difference between first year didactic sessions and this ACLS course stood in stark contrast: the former held information that may serve intellectual value, the latter could hold the difference between quality of life and brain death.

After leaving the session, Mackenzi suggested that we head over to Davis Island for some outdoor time. This place reminds me of many fond memories with friends during those first two years of medical school: by the water and with many lovely trees for slacklining. As we approached our customary spot, I saw a slackline already setup and many people attempting to hide in plain sight. Mackenzi had arranged a surprised birthday party for me!

About two weeks early, this served as the best time to get many of my medical student peers together for one last get-together. We enjoyed tacos and champagne. Joonsu definitely stole the show as my Tampa peers had not yet met him.

In retrospect, I wish I had realized how much this gathering of humans meant to me. After this week, all of us will scatter to the winds of residency. It will never be so easy to clear up schedules and coordinate travel to be together. I simply wish that we could’ve sat together in quiet contemplation, for just one moment, of this last hurrah.


The second day consisted mostly of practical elements and simulated codes. We spent the morning drilling IO lines in chicken thighs, running tubes into mannikin airways, and establishing IV lines in plastic arms. For the afternoon, we broke off into groups and ran through simulated patient scenarios as a team. One student took lead and the others assisted.

Mackenzi took the unruly first leadership role and we enjoyed a good start. Preceptors would control the mannikin patient: a computerized doll that shakes when shocked and blinks and even moans when in pain. A decent simulacra of a patient, especially since we can practice placing an IV in a scenario filled with alarming monitors.

So in short, that second day drained us. We had initially planned to attend the Commencement Dinner later that evening. However, after the wacky and long three days leading up to it, Mackenzi and I decided that we would be better served cancelling those plans so that we could recuperate our energies for the big day: graduation.


Graduation

We awoke on Friday morning with a buzz of energy about us. To pass the time until we headed over to the event grounds, we took turns working out and running the laundry. We decided to bring Joonsu with us to graduation, passing him off to our parents right before the ceremony began. We wanted some cute photos of him with us in proper doctor regalia. After all, he did already sit for a board exam.

When we arrived at the concert hall, we found the students abuzz with energy. Everyone in the green and black robes, looking like a uniform for an army of academia. Many fawned over Joonsu, especially those that couldn’t make the surprise birthday party earlier in the week.

One aspect of medical school that I will not miss is the difficulty in herding the cats. For whatever reason, the more advanced a student, the more challenging they are as a group to command. Imagine a closed room filled with two hundred cats. Now, imagine trying to get those cats in alphabetical order and to remain in line until the ceremony starts: you have an idea of how unruly the preamble to graduation.

We passed off the baby to Mackenzi’s parents, who took him for most of the ceremony. He fussed and cried for almost the entire time we were separated, unfortunately. Her parents did not get to watch her walk. I have a deep regret over this, as the geographical distance has led to emotional distance. I resolve to ensure my son’s connection with the maternal side of his family.

Graduation itself was a bit of a blur. Sitting on stage, facing the audience and the back of the podium, we received many remarks from speakers who actually couldn’t face us. A weird dynamic.

However, the speakers gave us their all. One of the hooders, or person that has the honor of bestowing a doctorate hood on a new physician, is a dear human that gave remarks after we all walked the stage. Knowing his story from a previous interview on the podcast, I loved that he could give us the closing words to the day.

And just like that, graduation was over. As we filed out of the concert hall, energetic madness descended on the theater as families attempted to locate graduates and graduated tried to corrale family for photos. After a weird and wacky day for us, and a very rough afternoon for the baby, we decided to hightail it out of there ASAP.

In retrospect, I wish that we could’ve enjoyed more time in that afterglow. Realistically, it was the last opportunity to see some of my peers. I will stay connected with a small group of these humans, however many of them will become social media acquaintinces or disappear from my radar entirely. I regret the opportunity to give some of these people an earnest hug and a goodbye. I would count myself lucky if I see even half of them in person, for the rest of my life.

And as we started on the road back to the hotel, we breathed a sigh of relief that the day was over. Medical school, too, was over. Two doctors and a baby beginning the long journey home: first to the hotel to sleep the sleep of the dead, then a 2hr flight, then to a new home in Pennsylvania and the end of a move.

However, right before we turned onto the highway to leave St. Petersburg and graduation behind us, Mackenzi told me that Joonsu has pooped.

I asked her, “How big? Can it wait or should I pull off now?”

“We should stop now.”

And I’m glad we did, because Joonsu had a severe stage two blowout. Feces everywhere: the baby carseat, Mackenzi’s arm, all over his legs. Everywhere.

Our first act as newly minted doctors: cleaning up our son’s poo.


Long Form Sundays

On Death Podcast

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