Medicine excites me; it is full of unanswered questions, unsolved problems and potential for growth. It is a limitless field, exploring everything from our biochemistry to our birth and death. Ultimately, however, the relationship between doctor, patient and community alongside the academic inquiry cements my passion for medicine.
My experience volunteering with St John Ambulance over the past 4 years means that I have had to build my own relationships with patients. Over time, I have become more confident and more relaxed about having – sometimes intimate – conversations with patients. For example, one long conversation allowed me to differentiate between heat exhaustion and an undiagnosed stomach ulcer, and another led to the discovery that a young woman’s unusual bruising was from her job as a beekeeper.
Again, the importance of communication in medicine was echoed in a work experience placement with the Northern Medical Centre, a central London GP practice. The doctor I was shadowing had to talk to her patient in Mandarin while simultaneously typing patient notes in English. I observed the real barriers to successful medical practice in a multicultural community and learnt that the most effective solutions were aided by discussions with patients, who already knew what wasn’t working and what might help. I found it fascinating to see how simple changes, such as inviting multiple family members to consultations, could make a big difference. I was interested to see how this was formalised by medical behavioural economics, which investigates how ‘nudges’ can significantly improve clinical outcomes.
During a hospital placement in gastroenterology at UCLH, I was able to see medical decision-making for myself in an MDT. I was impressed by the efforts of consultants to utilise the diverse skills in the room, using the meeting as an opportunity to liaise with multiple specialists. I was surprised to see that many patients had multiple unrelated conditions that straddled many medical disciplines. There is, I realised, growing room for new specialities on the cutting edge of medicine – one doctor I spoke with had effectively created their job as a consultant neurogastroenterologist. The connections between such disparate fields of medicine and how they come together to help and treat patients intrigue me.
My curiosity piqued, I then went on to look into the gut-brain axis in more depth. I was particularly fascinated by the aetiology of depression, in which gut microflora seem to play a potentially significant role. I particularly enjoyed ‘The Second Brain’, which gave me a deeper understanding of the enteric nervous system, helping me to understand how the gut can have such devastating effects on mental and physical health, and vice versa. This interplay between biological and psychological factors in disease is, for me, one of the most fascinating relationships in medicine. It is one of medicine’s current frontiers, with incredible potential for new discoveries that will improve patients’ lives.
I have also found that an understanding of my own psychology is valuable. Working long shifts with SJA has shown me how difficult it can be to recognise how tired or stressed you really are, especially when exhausted. Taking breaks and truly relaxing is important for me. Through my rowing and coxing I can unwind and forget everything but the river. I am very protective of my rowing and reading time. I also try to keep the words of the poet Horace in mind: ‘carpe diem, quam minimum credula postero’.
Medicine is a dynamic, compelling and caring field that I cannot wait to be a part of. I can think of no other ancient practice that has been so changed by modern life, and which is yet rooted in the same principles of kindness, competence and respect. I sincerely and eagerly look forward to following in this tradition.
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