The Only Dead People We Used To Know Were Our Cadavers...

Everything is a lot less "optimistic" second year of medical school. I'm not talking about my life, or the lives of my fellow medical students: I'm talking about patient vignettes.

Ah yes, the patient vignette. The only thing connecting your two years stuck in academia to the promise of one day being out there, in the real world, actually practicing a thing called medicine instead of learning and re-learning the Kreb's cycle.

M1 year, patient vignette's were short, simple, and straightforward. We were only given enough information to suggest a disease, it's symptoms, and its treatments. That's all we got and that was all we needed. Even by the end of the year, in neuroscience, we were still hearing only positives. When patients--real patient's whose stories were published in medical journals--suffered from strokes or rare hemorrhagic conditions we were always told that they survived the accident. It was pretty amazing that someone could survive such a severe intracranial bleed, but it made us hopeful for all the good we'd be able to do one day.

M2 year is nothing like that. The real people whose stories we read about and analyse, the real people whose flesh and tissue we stare at for prolonged hours, they were dying and now they are dead. If you are looking at a tissue sample in pathology, that tissue belongs to a person who died a long time ago. No attempts are made to hide the truth from us any longer: This man had a myocardial infarction. He died three days later. Here is his heart. It has coagulative necrosis arising from ischemia.

Even in the case of clearly fictional patient vignettes, things are inexplicably depressing. Here is a practice question from a pharmacology practice question:

A pregnant woman delivered by C-section when it was determined that the baby was in a breech position. After the delivery, she was given a prescription for codeine, a commonly used analgesic given after labor for pain associated with C-sections. The baby began to exhibit intermittent periods of difficulty in breastfeeding and lethargy starting on Day 7. On Day 12 the baby exhibited grey skin and decreased milk intake and was found dead on Day 13. 

I stopped reading after that.