“I remain entwined by the memories of days and nights in the E.R., and those memories would never let me go, not even if I were drowning.” –Dr. Pamela Grim M.D. from her book “Just Here Trying to Save a Few Lives”.I did not know him, he never played a part in my life, but I could not let a fall on the ice take his life.  I pressed my gloved hands on the gentleman’s frail chest, eyes locked on his face as I pounded rhythms on his sternum.  In those few moments, my own responsibilities and frustrations faded, and I viewed the man under my care as someone of my own blood.  Orders were barked, footsteps sounded from every direction, and red flowed into testing tubes, through gauze patches, and onto my gloves as the man’s wavering pulse jumped from life to near death.  I kept my CPR in rhythm, focus-driven and emotionally pleading for him to stay with us….until he did.  Skin once ashen returned to pink, his chest expanding with a breath powerful as one’s first.  As I stood back, I locked eyes with my patient, and his expression became forever banked in my memory. His eyes spoke the words he could not: “Thank you, I was not ready to go…”

Since I was young, I loved the Emergency Room for its unpredictability, tales of survivorship, and support when lives are lost.  However, I did not decide to pursue medicine until the end of college, maturity and experience had to mold and guide me toward a career not for temporary means, but for life.  The sciences gripped me strongly through college, I have an everlasting interest in anatomy (especially when it goes awry), and people from all paths of life fascinate me.  I am one who, late at night, sits with a blanket and watches Trauma: Life in the E.R., guessing the diagnosis while trying to find out more about and what could be done for the person in front of me. As college neared its end, I searched for a way to apply these various interests to real world exposure, and due to being heavily devoted to academics on a chaotic commuter schedule, employment was beyond reach.   I heard about internships, and like many, I had the image in my mind of someone serving coffee to a superior, not learning anything, or hearing from one who worked in an internship ending up hating the choice they made.  Despite my judgments, I was told through my advisors to make an appointment with the university’s Career Center.  Through discussion with them, I found the missing facet of my life, the tie combining interests I’ve had since birth to a few months in the real world: The Emergency Medicine Internship at Morristown Medical Center.  I applied and was accepted the following January.Medicine has an essential moment-to-moment connection with someone’s wonderful and horrifying times in life.  Those who wish to become part of it need a vital or powerful role alongside it as partners with patients, dedicated with the doctors.  Medicine’s career paths branch like the Celtic tree of life, interconnected yet variable, and for the premedical student, choosing a specialty to enter can be quite a challenge.  However, the internship provided me sheers to trim these branches with, narrowing down and shaping choices I made into a specialty I could not imagine my life without.  My first day as an intern was riddled with nerves, unsure of what to do, who to ask, and how to proceed with the new role I had in an environment I was thankfully familiar with.  To connect with patients, physicians, residents, and nurses who could teach me all I wished to learn, I had to take risk.  Nothing can prove one’s dedication and establish a mentor-follower relationship better than by asking questions.  Does a patient make you curious?  Ask.  Do you wonder how the doctor arrived at their diagnosis?  Ask. Does a patient’s family seem lost, hesitant, or reluctant?  Ask.  Priceless experiences could be the result of your questions, so ask, experience, and learn.

Are you drawn to emergency scenarios, restoring order from a chaotic situation? Take an evening (or more) as part of the Trauma Response Team. Does new life perk your curiosity?  Hold the hand of a woman giving birth or of her newborn to know the science and emotions of a human welcomed to the world.  Do the mind’s breakdowns go along with your strong listening ability?  Console psychiatric patients and their families, become the vital “someone to talk to” as they recover.  Do you get satisfaction out of working with your hands and mind in tandem?  Assist a surgeon with sutures and other procedures from Outpatient to Operating Room.  As an intern, I was blessed with these opportunities, yet I would have none of them if I did not question the physicians I worked alongside of.  Ask to do more than shadow, offer to do more than stand back and observe, and your dedication will be remembered by a patient, family, or doctor.  By offering yourself to medicine beyond a background role, lessons learned from these experiences can influence decisions regarding your future in medicine.  Many say we are shaped by experience, and this can be gained by questioning those around you, participating, risk-taking, and learning while growing intellectually.  Shape yourself by utilizing the world around you and all who walk in it, you will have no regrets by doing so, and in the end you will have enriching self-discovery.  The five months of my internship gave me more insight into myself then I could have ever obtained in five years.

When going into an internship, I encourage you to bring a notebook, one capable of fitting in a lab jacket pocket for example.  During the day, write all your thoughts.  How did it feel to sit alongside a dying patient, to save a life, to see life lost?  What was it like to tell a patient’s loved one their family member survived an emergency situation?  How do you feel in the different departments of a hospital, why do you favor one over the other?  Commonly, I would go into a patient’s room with this small notebook, pen at the ready, and take bulleted notes on their symptoms, interaction with the doctor and medical staff, and on their life in general.  I would write as though I was a film director watching a scene, observing fine details of body language to the grand reason why the patient was a patient in the first place.  If questions come to your mind while taking notes, write those down as well.  The collection of notes you acquire after the internship has passed can serve as valuable springboards for medical school applications, personal statements, jobs, and interviews.  Write all your experiences, lessons, questions, and thoughts, and when someone asks you why you choose to enter a certain specialty, the notes reflecting on your experiences in the internship can be attention-grabbing and heartfelt resources from which to provide the answer.

Lastly, an internship can be a time of comparison and contrast.  Combine observation and thought with every day of the internship, what have you seen that you will mimic for your patients?  What actions do you admire or refuse to imitate?  This is essential when observing bedside manner. Take note of the body language, words, and mannerisms of the physician and patient you are working with.  For example, one evening I worked with a physician who, instead of standing beside the patient gurney and staring down at them, would sit with eyes locked on the patient, hands folded, in a relaxed but attentive state.  I noticed the patient felt less intimidated, more comfortable, and open with the doctor who sat at eye level with her, listening and acting as an equal instead of standing over the patient, giving an already emotionally rattled person a feeling of inferiority or being intimidated.  The doctor’s body language allowed for more effective communication, a stronger feeling of trust, humility, and concern between the doctor and patient, ensuring proper information was obtained for efficient healing.  I vowed to take a similar approach with my patients, I wish for them to be partners with me during their recovery, and the physician’s body language I witnessed correlated with this personal value of mine.   With this in mind, I applied this body language to patients in my care, and I encourage premedical students to try this form of body language with a patient.  This observation and application of body language is an example of medicine’s favorite adage of “see one, do one, teach one”.

When the internship was complete, I was left with feelings of self-enlightenment, discovery, and priceless life experience.  What I had done for and learned from patients I will pass on to premedical students as I have done through this article.  When times of hardship strike, I find myself reflecting on the internship and its daily intellectual and personal gifts.  The memory of hugging a grieving family in solace, experiencing the chaos and order of every hospital department, and diagnosing alongside physicians provides personal strength, reason, and want to pursue medicine despite any obstacle.  As I have throughout my life, I support those who strive for their dreams, and I offer my timeless support as you enter medicine. Seek an internship, its value is irreplaceable, and its lessons forever valuable.   I hope you find your moment during the internship where, like the turning gears of a grand clock, every piece that creates your identity falls into an entire passion, a purpose in life.

In one evening during those five months, I saved the life of a man who, from falling on the ice, had suffered a full myocardial infarction.  My understanding of life and death, personal interests, values, and principles I’ve had since birth were encompassed into seeing my patient return to life.  My medical passions lit like lightning when I locked eyes with the man I once thought passed away, and for a moment, my breath was stolen from me.  Away from the patient’s room, my hands shook and my eyes watered as I realized I found my life’s passion.  I said to the doctor I worked with that evening, “I don’t care what I have to do, I must do what you do for the rest of my life.”

I entered the internship unsure of my life’s direction, but had I never applied, I would be lost on the ocean of uncertainty still.  As you advance into your life and career in medicine, may the memories and lessons of your experiences guide you through hardships and victories.  Take and utilize the lessons from an internship to future patients, families, and medical students that may one day turn to you for guidance.  Let the internship be a partner, like a patient to a doctor, in shaping your life’s dream piece by piece.  Never be afraid to be curious and ask questions, the answers will become a solid foundation for creating one who understands what healing entails.

Desiree Hykes is a Drew University Biology Honors graduate, seasoned theatrical performer, and has obtained multiple awards for her artistic interests and academics.  With her passions for the sciences and humanities such as Anthropology, she is pursuing medical school to become a New York City based Trauma Surgeon.