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Stethoscope Ceremony

So, just today I stood for my anatomy oral exam. Best part about doing this at Stanford? Because our professors-dear dear gentlemen both-are British, it’s perfectly acceptable to respond to all questions in the quirky pronunciation of Merry Old: ca-PILL-ary, pul-MOAN-ah-ry, tra-CHEE-ah.

Anyway, point is, for the first time in a month, I’ve the time to write again. For a warm-up, I thought I’d try to bring this blog closer to up to date. Then it’s on to see what I can do about those Spellwright edits my editors been making noises about.

So after we return from SWEAT came a few days of orientation. Largely this was the same as it is for all institutions: here’s the libarary’s website, here’s your class website, here’s your ID and a website you can use to keep tabs on it, blah blah blah. We did get a few exhortatory speeches about challenges we would soon face and the resulting personal changes. Though we prepared for bouleversements of perception and character, nothing much happened. We spent days listening to professors, nights drinking beer in graduate housing…

…until the evening before classes began. To mark the occasion, there was a small but official soiree. Most schools call this a “white coat” ceremony, in which a grand panjandrum welcomes the first-years into their new profession and drapes them with badged, personally embroidered white coats. One’s parents and/or paramour attend to snap photos and beam at their future doctor.

Mostly that’s how our shindig went down, with the slight difference that we received only stethoscopes. Badgeless white coats, still wrapped in plastic, had already been distributed during the meet-your-advisor portion of orientation. More than a few students, including me, felt a sharp sense of disappointment. We had worked so hard to come here, and despite the promise of our coming metamorphoses, we had detected no discernable change. To sport a white coat before friends and family-well, that’d new; that’d be a clear sign that change had begun. But alas, the higher-ups had organized a stethoscope ceremony instead.

Some of us cheated. We toted our white coats to the dinner, threw them on for quick family pictures. My personal favorites are those of me with my niece. But when the dinner ceremony began, the white coats came off and the usual blazers and dress jackets took their place. There was more than a little grumbling.

But when Deans Prober and Pizzo took the podeium, all grumbling ceased. The deans presented a brief history of the stethoscope and offered it as a symbol of connection between the patient and the doctor. The more I thought about this the more appealing the metaphor became: a stethoscope is after all the physical bridge that conveys the sounds of the patient’s lungs, stomach, heart into the doctor’s ears. This came into sharp contrast to that of the white coat: it’s a bit of uniform, costume really, used to identify doctors and separate them from the patients. Though I’ll admit that costumes can have powerful and beneficial effects, I immediately appreciated that Stanford-so often stereotyped as a research institution out of touch with the clinical medicine-was encouraging us to think of and value those things that connected us to rather than separated us from our patients.

After that point, the evening passed far too quickly. Our names were called; we walked across a small stage received the aforementioned symbol of connection and shook deanly hands. Then there was another salvo of pictures, this time with the now-treasured stethoscopes draped around our necks. We congratulated each other as if we had actually done something and then drove off with our families.

That night I pawed through my new text books and paced nervously until I got it into my head to try out my new stethoscope. I did this sitting in bed by the soft light of my reading lamp. In three weeks, I would know the sounds the body makes are subtle and soft. I would know they were hard to hear and harder to interpret. I would know how to land the stethoscope’s diaphragm over my xiphoid to hear the thud of my tricuspid, over the apex to her the bicuspid’s clap, to the left or right of the angle of Louis to listen to the aortic or pulmonary valves. But on that night, I ranged the diaphragm and bell across my chest and belly, unaware of that I was hearing much of anything at all.

But I eventually found my slow, quiet heartbeat. It was then I finally to feel the long expected change: something of anxiety, a tightening around the stomach and throat, but also a warmth in the chest, the beginning of a feeling I hope sustains me in the long years to come, a feeling of wonder.

This same wonder would return more strongly in cellular biology lecture or in the dissection room. But that night it was fleeting. Soon bored, I got out of bed to do as a classmate had suggested and put the stethoscope above my laptop’s hard drive as I made the computer open large files. The resulting cacophony of insect-like chirping, whirring, and creaking-though entertaining-felt alien and cold. And I was soon back in bed, falling into sleep, and listening to the faint ebb and flow of my own blood.