Doctor In the Making

By Samuel D. Hobbs

Do you ever wonder who your doctor is behind the professional façade? Or ask yourself what it takes to succeed in the practice of medicine? DOCTOR IN THE MAKING is a witty yet strikingly honest memoir about a young man’s journey to become a physician. In this book, you’ll discover how to:

• Prepare for a career in medicine (or anything else!)
• Reflect on personal values in times of adversity
• Recognize and make use of transformative life experiences
• Stay true to what is most important
• Be the best you

If you are interested in the practice of medicine, feel overwhelmed by your circumstances, or simply want to reconnect with things that are most important, then this is the book for you.

• Language: English
• Publisher: Lulu.com
• Release date: Sep 3, 2017
• ISBN: 9781387207701

Book preview

Doctor In the Making

Doctor in the Making

SAMUEL D. HOBBS

COPYRIGHT

Copyright © 2017 Samuel D. Hobbs, Albuquerque, New Mexico

All rights reserved. No part of this book may be reproduced in any form or by any means without permission in writing from the publisher, Samuel D. Hobbs, [e-mail].

Library of Congress Control Number: 2017903479

ISBN (eBook): 978-1-387-20770-1

For Kiley

INTRODUCTION: Why You Should Read This Book

DO you ever have one of those awkward conversations when you first meet someone? The one that start with So, what do you do?

And then you think, How in the world am I supposed to answer that? I’m a student, but I ‘do’ so much more than that. You play it safe and politely answer, I’m a student.

Oh, that’s nice, comes the response, then the next question, as if it is all scripted: What do you study?

Sometimes, I decide against playing it safe. I dropped out of high school, and now I do whatever my heart desires, like go to medical school. The looks I get are priceless.

You dropped out of high school?

You know you can’t go to medical school if you drop out of high school, right?

How do you plan on becoming a doctor?

The truth is, I will be a doctor in a few short months. During my first year of medical school, we were required to do an ice breaker activity with other students in our class. I sat next to an intimidating student named Alan. He was obviously very intelligent, and before we even did the activity I knew that he had a PhD in Russian History and could speak Latin fluently. We were asked to share something about ourselves that the other person wouldn’t be able to guess. Wanting to shock him a bit, I told Alan, I dropped out of high school.

With a look of disbelief on his face, Alan said to me, No way. That was exactly the thing I was going to share!

At a recent meeting to discuss methods to improve medical education, twelve physicians and medical students sat down to have lunch, and I was invited to attend. We had an ice-breaker at the beginning of the session, and we were all shocked to learn that three of the twelve were high school dropouts.

As it turns out, your doctor might be a high school dropout. And it may be one of the primary reasons they were selected to go to medical school. Diversity is a term used ubiquitously in the education sector, meaning that administrators and officials at higher education institutions no longer want cookie-cutter students to be the majority. Because of this, you can expect diversity among your college graduates, your lawyers, your engineers, and, importantly, your doctors.

Do you know who your doctor is behind the professional facade? Or the experiences that brought him to this stage in his career? Do you know what she went through to have the privilege of taking care of you? And, if you want to become a doctor, how should you prepare to stand out during the selection process? When should your preparation begin?

I am an Eagle Scout, a nurse, a marathoner, an author, a musician, a husband, a father, your future doctor… and I dropped out of high school.  This is a book about transformative experiences, the things in life that change us for better or for worse. Every doctor that I know has a vibrant past with numerous transformative experiences that brought them to the study and practice of medicine. Without those experiences, we are nothing but soulless, cookie-cutter students with no other purpose than to eat, drink, sleep, and study medicine.

To be successful in the practice of medicine, as with the practice of most other careers, you must stay true to those things that are most important to you. Sadly, we often lose sight of the things that matter most, and our daily experience might turn us into something we never intended to be. Lucky for you, I am writing this book so that you can learn from my mistakes and be more successful and happy in your chosen career. The transformative experiences that you have are a force for change, both positive and negative.

Since I am writing about my own experiences, I have changed several names and altered the specifics of some events to protect the confidentiality of my colleagues and my patients. Despite these changes, I did my very best to stay true to the experiences that made me who I am today.

Okay, I’m rambling. I hate long introductions and prefaces and the like. So, without further ado, I give you: Doctor in the Making.

SECTION ONE: The First Call to Medicine

ONE: I Hate Nursing School and Decide to Drop Out

HEY pizza face! Pepperoni skin! Zitty Pimpleson! I can map a constellation on your face! As a twelve-year-old, I enjoyed learning new ways to torment my older siblings. I would smile broadly as I called out nicknames and taunts. It was my way of getting back at them for the way they picked on me, but I didn’t realize the effect that words could have until I was their age.

My first pimple appeared just days after I turned thirteen. When the taunts that I had freely delivered were directed back at me, my spirits fell, and I tried to hide myself and avoid social contact. When my mother heard what was happening, she repeated her timeless advice. She would say, Sticks and stones, Sam, sticks and stones. As the adage goes: Sticks and stones can break my bones but words will never harm me. But the words hurt worse than sticks. Bruises heal over weeks. Even broken bones could mend themselves. But what about a broken spirit? A shattered sense of self-worth? These were topics that weren’t discussed openly in my home, and the pain did not subside. My brother would repeat the rhyme, I’m rubber, you’re glue. Whatever you say bounces off me and sticks to you! I thought about that and tried to imagine the bullies at school insulting themselves. But, no matter how hard I tried, I was the target of the jokes, I was the one being shoved into the dirt.

I was afraid to look at my friends. Whenever my eyes met with those of another, I could see their eyes dart around my face, and I quickly dropped my gaze in shame. And it didn’t help when I blushed: the blood rushing to my face would only emphasize the dark, reddish-purple protuberant masses. I despised the fact that I had acne while others did not. My grades suffered because of my lack of confidence. I constantly felt like I was being watched and judged by my peers, and my thoughts were potent enough to withdraw my attention from what was being taught in the classroom. I transformed from an extrovert to an introvert. To numb the pain and temporarily forget my woes, I spent my free time playing video games. One problem snowballed with another, and I began to suffer from a sedentary lifestyle, which did not help my feelings of low self-worth.

I am the first to admit that I was an awkward middle-schooler. In addition to the acne, lack of eye contact, and video game addiction, I weighed just less than a baby elephant, wore both braces and glasses, and played viola in the middle school orchestra. I hope you have a clear picture of me in your mind. What’s the first word that comes to mind when you think of an overweight teen with acne, braces, and glasses who plays in the orchestra, is obsessed with video games, and has very few friends? Nerd. I was a nerd through and through. But I was a nerd who secretly wanted to be accepted, not knowing that my outward appearance and attitudes repelled the acceptance of my peers.

I cried a lot that year. By the time high school started, I desperately wanted to start anew, to regain my self-confidence, to make new friends and be a new me. I began to work harder in my studies to get straight A’s in all my classes. I gave up video games and I started wrestling and working out to get into better shape. I even wore contact lenses to ditch the glasses. I tried to be more outgoing, but again, my acne got in my way. I had wonderful friends from my church that accepted me for who I was and who helped me feel that I was accepted, but I still had difficulty maintaining eye contact. My head would droop, and I hoped that the top of my head looked better than my face to the hundreds of students who passed me in the halls. By the time I was a sophomore in high school, my acne had gotten much worse. I saw Charlie, an old friend from middle school, in the hallway. He did a double take when he saw me, and we stopped to chat in the hall before our next classes began.

Dude! he called out. Sam, is that you? What happened to your face? I could feel my cheeks flush, but of course, there was no hiding my pimples.

Umm, I’m seeing a dermatologist to see if I can get any better, I responded reluctantly.

Well, we should hang out some time. It’s been way too long! Charlie wandered off towards his next class and left me to my thoughts. I needed to clear up my acne. What I wanted more than anything else was to look like those lucky high school students who had flawless skin. I went home that night and cried. Although crying wasn’t an uncommon event for me those days, that night was particularly bad. I locked my bedroom door, pushed my face hard into my pillow, and let out a wail of distress that had been building up inside of me for some time.

MY crying did not help. What I needed was a miracle. I knelt next to my bed and offered up a prayer to God. I was in the habit of praying morning and night, but that night my prayer was a little more meaningful. I spoke with my Heavenly Father as if He were standing beside me. I told Him how I felt. I cried to Him and imagined that I was bathing His feet in my tears. I felt broken. I had lost my drive to continue.

Then, a miracle did come. It was a gentle touch, a soft feeling that overpowered my body. It felt like a warm blanket was wrapped around my shoulders. I was five-years-old again, and my parents were drying my tears and wrapping me up, telling me that everything was going to be all right. But there were no voices, no physical arms around my shoulders, and no one in my room but me. Somehow I knew that my prayer was answered, and my Father had given me the strength I needed to bear my trials with patience.

The next week, I returned to my dermatologist. I told her in my timid voice that I needed to try something else, something more effective. My mom chimed in and asked about a medication she had heard about, something called Accutane.

Isotretinoin, the generic name for Accutane, is the last resort option for acne, she explained to us. Imagine the difference between a peashooter and a nuclear weapon. The peashooter is merely a toy. A nuclear weapon can take out an entire city. Well, the treatments that you have been on are like that peashooter. Accutane is the nuclear weapon of acne medication. However, it is the last resort option because, frankly, it is dangerous!

My doctor went on to explain to me the drawbacks of the medication. I would require monthly blood draws to ensure that my liver was functioning properly. Isotretinoin is also a systemic chemotherapy agent, which can cause toxicity and damage to literally every part of the body. Some other common side effects include: decreased blood cell count and immunity, depression and suicidal thoughts, dry skin and eyes, rash, joint and muscle pain, and increased cholesterol. Women who take isotretinoin must be on birth control as well, and if they are sexually active, they sign an agreement to always use at least two different forms of birth control. The hallmark side effect of isotretinoin in pregnant women is atrocious birth defects. Because of this risk, I also agreed not to donate blood (even though I have the coveted O-blood type) both during treatment and a year following termination of the drug.

After learning about the risks and benefits of isotretinoin, I decided that it was my best option. I had a baseline set of blood work completed, and I signed the appropriate documents (along with my mother) to release my physician from all liability and promised I would not sue if I experienced any permanent, debilitating effects from the treatment. I also promised not to donate my blood. The day I received the written prescription from my doctor, a new hope was kindled within me. I dreamed of clear skin, and I knew that the treatment would work.

ONE week after I started treatment, the unthinkable happened: my acne exploded. Not only was I getting new, large, and grotesque looking pimples on my face, they were now appearing on my back, chest, arms, legs, and other unmentionable areas of my body. After calling the dermatologist, she assured me that this was a normal part of the treatment and that the pimples should start fading within the next couple of months. So, I waited patiently. At school, my peers no longer made fun of me. My acne was so bad that jokes made at my expense were too cruel even from high school students.

Luckily, my doctor was right. Little by little, over the next few months, my acne started to melt away. Pimple by pimple, white head by white head, black head by black head, they disappeared. Every single one. It was the miracle I knew would come, and I knelt in prayer as before to thank my Heavenly Father for curing me of the most disfiguring disease of my life. Over the next several years, I required two more treatments of isotretinoin because of recurring acne, but it never returned to the severity of my first two years of high school. Now, I continue to live with some permanent side effects, including dry skin and eyes. I could never again wear contact lenses because my eyes would get irritated. If I didn’t put lotion on at least every morning and night, my skin would start to flake and peel off. It wasn’t pretty, but I couldn’t be happier. I found a new life after a kind dermatologist walked me through the recovery process.

BEFORE my sophomore year of high school had ended, I went to the dermatologist’s office for a follow-up appointment after finishing my first round of isotretinoin. One of the receptionists looked at me curiously. You look different… she said hesitantly, and I happily replied, I know! My skin is finally clear.

The receptionist shook her head and said, No, it’s not that. There’s something else about you. You have such a beautiful smile! When she said that, I blushed. However, her words rang true. I realized that it had been years since I had really, truly smiled even when I was happy.

The dermatologist noticed it too. You seem much more confident than when I first met you, she said with a smile.

I know, I replied, and I want to thank you for everything you’ve done. You have given me a new life! I couldn’t ask for anything more. In a few short years, my self-worth was completely restored, and my confidence was on the rise.

Sophomore year of high school was a major turning point in my life. Did I mention that my braces came off that same year? Almost from one day to the next, it was as if a light switch had flipped. I went from being a nerd to being a geek. You may not think that is noteworthy, but I assure you that it is. I had clear skin, straight teeth, good grades, and confidence to try new things that would have frightened me before.

During that school year, I heard about a high school nursing program offered through the public-school system. I was sitting outside with some friends from church when my friend Bryan sat down wearing scrubs. He was animatedly talking about his day.

…The smell was so bad! And the sound of crunching bones when the retractors went in – it was disgusting. Then, the surgeon dumped a bunch of slushy ice on this guy’s heart, and it just started spazzing out! How freaking cool is that?

What are you talking about? I asked, noticing how he had captured the attention of everyone at the table.

I just saw an open-heart surgery, Bryan said with a grin, and it was the coolest thing ever!

How did you get to see that? I secretly wanted to be just like Bryan, experiencing awesome things and seizing the attention of my peers.

I’m doing this high school nursing program, he answered. It is the greatest program ever. Bryan convinced me that the nursing program was the most incredible opportunity anyone could ever dream of, even though I had no idea what a nurse’s job entailed. I had to become a nurse, and I had to be like him.

That year, I applied for the nursing program, committing to drop orchestra or any other class that would prevent me from enrolling into the program. I went to the nursing school for a rigorous testing process and discovered a flaw in the mathematics, science, and English computer-based exams. You could technically take the competency tests as many times as you wanted, if you logged out after each attempt and re-entered your information. Since I was a fast test-taker, I took each of the required entrance examinations two or three times, securing 98-100% on each of the exams.

Next came the interviews. I was more confident than I had ever been in my life, with a clear face and no braces, although I don’t remember a single question that I was asked in the two interviews. I remember answering with confidence and feeling positive that I had been accepted to the program. It was not until much later that I realized how poor my odds had been, with over 200 applicants and only 50 available positions. Of the 50 students who were accepted, less than half on average graduate from the program. Those who left the program either dropped out or scored less than the required 75% in at least one of the courses.

That summer, I received an official acceptance letter into the nursing program, congratulating me on my academic achievements and listing several items I needed to purchase prior to starting the program. I had been accepted into the only accredited high school nursing program in the country, which was funded by the public education system, and I had yet to celebrate my sixteenth birthday. How lucky was I? 

THE first semester of nursing school was easier than I anticipated. From labs on hand-washing technique to making beds without pressure ulcer-causing wrinkles, I secretly thought the course material was lacking in complexity. Then we learned about the surgical hand scrub and how to change the linens on an occupied bed, and things became a little more interesting. Next, we learned various procedures, including giving shots (I limped for a week after I acted as the pincushion for one of my nursing buddies) and placing nasogastric tubes. Finally, we were ready to start working in the hospital.

Imagine the difficulty of starting clinical rotations as a 16-year-old high school student. Each morning, I would wake up between 4:45 and 5:00am to shower and eat breakfast before my first zero-hour class, which started at 6:00am. Between classes, I would take advantage of our 15-minute breaks to catch up on studying. My friends would tell potty jokes at lunch while my head was tucked behind a textbook, studying diligently for an upcoming exam or frantically trying to work on homework that was due that same day. I would leave my regular high school at 1:00pm each day and drive to the hospital. Since the drive was long and I would often run late for my rotations, I had no choice but to change my clothes in the back of my compact Toyota Corolla.

The Hospital of Veterans Affairs (VA) was the first place that I was assigned to work. We started slowly, focusing our care on one or two patients until we felt competent in the basics. It was up to our nursing instructors to decide when let us go home. I usually didn’t leave until 7 or 7:30pm each evening, which left me very little time to change, have a bite to eat, and do a bit of homework before collapsing in my bed each night.

During one of my first weeks of work at the hospital, I had a very pleasant and elderly patient named Paul. He was diagnosed with pancreatic cancer, and he was recovering from a Whipple procedure where several important structures were removed from his abdomen (including his pancreas and part of his small intestine and liver). I sat with him and talked about his days serving in World War II. He was a gruff old man, having been changed by the things he saw and did during the war, but he had a soft spot for young people like me.

Although Paul was strong enough to talk, he was too weak to take care of his personal hygiene. I put my newly-acquired skills to the test as I gave him a bed bath and gently shaved his face. The way in which we bonded was a unique experience for me. Paul was the first patient who died while in my care.

The following day, I tried fake a smile for my high school friends, but they didn’t buy it.

What’s wrong? I was asked several times.

Holding back the tears, I would shrug it off. I had a patient die yesterday, and it’s been a little tough.

Oh, I’m so sorry, they would reply. And then, awkwardly, my friends would change the subject or strike a conversation with someone else. I could no longer relate with my high school friends. The things that I wanted to talk about, that were important to me, were not the gossipy, trendy topics that interested my peers.

Luckily, my parents were willing to listen. They would laugh at the funny stories of working with patients and get grossed out at just the right moment. And when I told them about having a hard time with a patient passing away, they let me cry and didn’t offer any advice. They were there to support me through these difficult years. Friends in nursing school offered similar support. My closest friends became the ones with whom I worked in the hospital. We knew each other’s challenges, and we could freely share our experiences without feeling judged.

Soon after Paul died, I started taking care of Mr. Jensen, a one-legged, elderly man with dementia who had recently been hospitalized with pneumonia. After his lung infection was treated with antibiotics, Mr. Jensen developed horrific diarrhea, the kind that can make the entire hospital smell of death and that could linger in your nostrils for days at a time. Mr. Jensen could usually make it to the bathroom on time, but as the diarrhea worsened, we had to keep him in briefs to catch the fluids as they spewed out. To change his adult diapers, all staff were required to wear a full gown and gloves to prevent the spread of his Clostridium difficile (C. diff) bowel infection.

One day, Mr. Jensen called for the nurse. It was 7:30pm, and I had a lot of homework that needed to get done before going to bed that evening. Quickly, I poked my head into Mr. Jensen’s room. He was sitting in his wheelchair. Yes? I asked, tapping my foot and glancing at my watch. He didn’t seem to notice.

I need a diaper change.

Okay, I sighed, exasperated. What a time to ask for a diaper change! I thought. I quickly donned a gown and gloves and entered Mr. Jensen’s room. I smelled the stool before I saw it, and I knew I would need extra wipes for this one. Mr. Jensen stood up on his one leg, supporting himself on the dresser, and I quickly pulled off the brief. Holding my breath, I managed to clean off his bottom and put some cream on the rash that was beginning to develop.

I turned to get a new brief, and that was my mistake. The moment my hand reached the new brief, Mr. Jensen decided that he had to use the bathroom again. Only, he couldn’t wait for me to put on the new diaper. In an instant, he coated my white, barely-broken-in nursing shoes with watery, brown, foul-smelling splatter. My scrub pants were mostly saved by the gown that I had on, but I could feel disgust swelling in my own bowels.

After calling housekeeping, scrubbing down my whole body in the bathroom, and finishing my last bit of paperwork, I broke down in tears. One fellow student witnessed my pain, and in a true act of compassion, she helped me wipe down my shoes and didn’t say anything about what had just happened. I drove home and arrived late, distraught, and ready to give up on my dreams of going into the medical profession.

After sacrificing sleep to finish my homework, I finally spoke to my parents about what had happened to me that day, and a flood of emotions surfaced. I cried, and I said that I wanted to quit nursing school. I wanted to quit everything and go to college early like my older brother. My idea of a break from the real world of nursing was to go to college early. I was sick and tired of losing my friends, of studying and doing homework during all my free time, and of pretending to be an adult when I was still just a kid. I wanted a normal life – I wanted to be like my friends.

Sam, my mom told me sincerely. "You do whatever you want. We will support you in what you decide to do. Drop out