Ten Questions You Always Wanted to Ask a Medical Student
"The corpses we train with are preserved for about half the year, but by the end of the semester, they start to get moldy around the abdomen."
Photo courtesy of Harri
This article originally appeared on VICE Germany.
Despite what's often suggested in hospital-based TV shows, not all medical students use a handy IV drip to get rid of their hangovers. But Harri has definitely thought about it. "It would absolutely work," the medical student told me, "though the problem is you'll need to get an equally wasted colleague to start the IV, which isn't very smart."
The 27-year-old is in his fifth year of medical school in a major German city. Harri asked that I keep his real name and location a secret, so he can freely talk about what it's like to tell someone they're going to die, the hardest parts of the job, and whether students ever steal drugs from hospitals.
VICE: Are you always respectful when handling corpses?
Harri: Generally, we're very respectful. And they don't really allow students to work on the bodies alone—there's always someone around to supervise us, just to make sure that everyone treats them with respect.
There was this one time, though, right before an exam, where we had to slice some skulls in half to remove the brain and examine the neural pathways. Before the test, I practiced on several different heads, since I'd also be tested on working with a range of skulls. So, of course, I took two different halves and put them together for fun. But who wouldn't do that if given the chance?
What do corpses smell like?
They smell of their preservation agent, formaldehyde. Normally, the inside of a dead body turns into pure sludge, but the chemical helps keep the organs firm, making it easier for us to work without damaging them. The corpses are preserved for about half the year, but by the end of the semester, they start to get moldy around the abdomen.
Do you and your colleagues practice taking blood on each other?
Yes, absolutely. During one of our early classes, I accidentally sliced through my friend's veins. Sometimes, the veins are just too thin and they split, and other times you push right through them.
We actually practice lots of different techniques on each other. For example, we do ear and nose examinations on other students, which are really disgusting because they involve sticking a small set of forceps into the nose before opening them, allowing you to see clearly down the nasal passage. I was also worried that my conservative study partner would find some leftover drugs stuck up my nose. If he ever did, he kept it to himself.
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Do medical students take more illegal drugs than the average person?
No. I think we experiment less than humanities students. But those who do don't hold back. Maybe it's because we know exactly how drugs work and think we can control it. Or we think that being surrounded by other doctors means someone will look after you if something goes wrong. But it's really a bit idiotic because we should know better.
Do you steal drugs from the hospital?
I once stole a bottle of ketamine from the intensive care unit. It doesn't fall under the Narcotics Act in Germany, so it wasn't kept in a safety cabinet. But it's not a very common thing to do—I don't know anyone else that's stolen something, and I've only done it once. I've gotten myself into a bit of trouble from time to time, but if they had caught me then I would have been kicked off the course.
What's the hardest thing about the job you're preparing for?
Almost every day, someone dies in intensive care. Many of these patients, however, are anesthetized and on life support, so they’re not exactly running around the place. That's why their suffering almost feels more abstract than terminal patients in other wards. I find working with oncology patients—the ones who are really near the end and need in-hospital chemotherapy—to be the most emotionally difficult.
Who was the first person you saw die?
My first was probably my hardest. I was around 19 years old, working my first nursing internship. We had a patient in her 40s who was originally diagnosed with ovarian cancer. She had been ill for a long time and had already undergone multiple surgeries—she knew she was going to die.
She had a tube inserted into her abdomen so we could pump nutritional supplements directly into her stomach. One day, I went into her room and immediately knew that something was wrong. A section of her intestine had split, which meant that its contents were now spilling into her abdomen. Almost as soon as the surgeon arrived, he explained to the patient and her husband that she needed an operation as soon as possible. All three of them knew that she wouldn't survive it because the chemo had completely knocked her—she weighed 35 kilos [77 pounds]. Immediately following that conversation, I wheeled her bed into the operating room and had to watch as her husband walked alongside us. Then, they kissed and said their goodbyes.
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How do you learn to tell someone that they're dying?
There are two courses, called "Breaking Bad News" and "Breaking Worse News." In both, we have to role-play different scenarios, working with professional actors pretending to be terminally ill patients. First, we're taught key phrases, before learning specific conversational techniques—verbalizing, paraphrasing, and active listening. Now, anyone with a bit of common sense and empathy really doesn't need to be taught all of this. But there are so many socially awkward medical students that I'm happy they're forced to take these courses before they're let loose on dying patients.
Do you need high grades to become a decent doctor?
No, it doesn't always matter what grades you get. Sure, being smart is a prerequisite, but empathy is just as important, and that can't be tested in an exam. There are plenty of smart students who make bad doctors—people who achieve the highest grades but have no idea how to actually deal with people. Or the only reason why they became a doctor was that one of their parents was one. You can only hope that those people go into research and never set foot in a hospital room.
Finally, which jobs do you find disgusting?
I've seen some nasty stuff in the emergency room. But outside of that, probably patients who smell badly. I can't hold my nose or make a scene in front of them, but there are some tricks. One is to douse a surgical mask in disinfectant—it almost numbs your mucous membrane, so the only thing you smell is the disinfectant.
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