Kathy's Diary

As part of a new accelerated program that enables students to earn their M.D.s in as little as six years, the University of Michigan assigns pre-med sophomores to spend a month in the field with a physician on his daily rounds. Explains Dr. Robert Johnson, director of the field course: "We want these young people to find out if they have the aptitudes for a career in medicine, as well as to get firsthand experience with the patient's side of medical care." If the experiences of Kathy Makielski, 19, are typical, the course is apparently accomplishing its goals. Kathy, who spent her month with a family doctor in the small city of Allegan (pop. 4,516), kept a daily log of her experiences. Some excerpts:

Monday, May 21: Dr. S. picked me up at 7:30. I changed into clothes for surgery (gown, hat, shoes, mask)--the first I'd ever seen. I stood on a platform and watched it all. Lots of joking and irrelevant discussion. They have jokes about sponge counts: never any left in, but nurses have miscounted upon occasion.

Wednesday, May 23: Dr. S. thinks most doctors overprescribe, and he tries to watch out for it in himself. On telling bad news: be honest but keep hope open. Notes taken later that day: doctor wears sports coat on rounds, white coat in office. I should ask him why. This afternoon doctor saw someone who was thriving on the secondary benefits of illness: a girl who apparently sprained her arm. What she really wanted was a sling to show off and get attention.

Friday, May 25: Well, this morning started somewhat differently. Dr. S. called at 7:15. Did I want to watch a delivery? Yes! It's so wonderful when the baby finally comes--a boy. I strained and worked right along with [the mother]. They had to cut her to enlarge the opening (I forgot the word for it).

Tuesday, May 29: Dressed for surgery, watched a tubal ligation [a common sterilization technique] on the same woman whose delivery I watched last week. It's weird the way innards are all sort of loose, in that the doctor can just stick his hand in there and poke around.

Tuesday, June 5: After lunch I saw an autopsy. Here's what's freaky: it was the lady whom Dr. S. put a pacemaker in last night. She died about 1 a.m. I can't believe it. I was just talking to her yesterday. Now she's dead and cold to touch. The autopsy room smelled disgusting. I had to keep breathing through my mouth and telling myself "Think clinical."

Friday, June 8: Dr. A. [a colleague of Dr. S.'s] had a nasty thing to do this morning. He had to inform Mrs. C. about the status of her lungs. First he told the basic reason for asking her back so soon--abnormal chest X ray. Now here's what shocked me, and very definitely shocked Mrs. C. a hundred times worse. He said, "I know what's at the back of your mind--cancer (pause), and it very well could be cancer." She fell back against the table. Dr. A. was called out for a minute, and that time was the most silent, tension-filled, long time that I've been through for several years.

Monday, June 11: My last week. Where has all that time gone? I saw Dr. M. do a hysterectomy, and then I went to visit with Mrs. T. before her surgery. I hate to think about leaving, because now I'm seeing some continuous-care people coming in for rechecks.

Wednesday, June 13:1 met with Dr. Z., who was visiting from "Kazoo" [Kal-amazoo]. She's married to a hematologist and has a family. I wondered how she and her husband had their mail addressed: Dr. and Dr. Z.? She said she went by Mrs. because it's the harder title to keep.

Friday, June 15: I'm glad I'll have a record of all this. I'd rather someone stole my purse than my journal.

Looking back at her experience, Kathy believes that it convinced her that she ought to stay on in medicine, overcoming her earlier reservations about the expenses and grueling study that lie ahead. "It turned me on," she says. "I want it more than ever now."

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