remembering that one test where i got the question right because i am too dense
it was a practical test. OSCE practical tests in med school are torture. they lock your whole class up in a room to wait, then take you out in groups of five. watching your classmates form a line and be marched out of the room feels like waiting for your moment to be sacrificed to the old gods.
the room was on the highest floor of the building and there were some guardsman-type people who stayed inside to make sure we weren’t looking at our phones, even though we had to leave them behind and even though we go through metal detectors to enter confinement and every time we went to and back from the bathroom.
the guard people let us talk among ourselves and study, but they always went “get away from the windows” if we approached, and i could never quite figure out if they were worried about someone morse-coding us the answers with a flashlight one building away, or if they were scared we were going to jump.
OSCE is basically an oral test: you stop by the door and there’s a little clinical story on the door, followed by a few questions. you have two minutes to read the case. the case is very long. the questions are very vague. a high pitched bell rings and signals you should enter the room. inside the room there’s a professor and you have to verbally relay the answers and sometimes execute the proceedures the question asked of you.
the professor has a little checklist, a list of the things you’re supposed to say, and if you say them all you get all the marks, and if you don’t, you get a zero for that checklist point, and this corresponds to around 40% of our final grade. because the questions are very vague - eg ‘how would you handle the case and what would you prescribe’ - it’s very easy to miss things and forget them.
you have to say the exact things on the list. i mean the EXACT things. it is a nightmare. sometimes the professors are really generous and they look at their checklist, then look at you with this exhausted dead-inside expression and go “You forgot to say where you’re treating the patient.”
and I’m very grateful for the hint, but also very frustrated, because I SAID I’M DOING A SURGERY, OF COURSE IT’S IN A HOSPITAL, WHERE ELSE WOULD I DO A GODDAMN SURGERY
so i give them an equally dead-inside look and go “I would like to hospitalize the patient” and they tick the fucking thing on the fucking list this is the worst fucking way to evaluate literally anything i hate it so much
sometimes, though, the professors are dicks and they infer that although you said “perform a surgery”, you didn’t say where, so you obviously meant it in the middle of a shopping mall or on top of a moving truck, where surgeries are usually performed. therefore you deserve a zero.
each OSCE question is timed and lasts five minutes. when time runs out, the bell rings again to signal you should move to the next question. we can hear the bell from the confinement. i need you guys to understand that this is torture. i always volunteered for the first groups because staying in confinement hearing the bell ring for over an hour made me want to cry. students sneaking each other anxiety pills were common.
me and my friend had a ritual that we always walked out the door humming summertime sadness by lana del rey. our very own cthulhu sacrifice hymn. for good luck.
anyway so I’m doing this OSCE examination and for some questions they bring actors to pretend to be patients, while the professor stares at you talking, in silence, like some sorta edward cullen in a whitecoat peeping you in your sleep, ticking things on the little list. it is about as miserable as it sounds.
this question had an actor, and the actors are just kids from theater school who need some cash so i sympathize with them. the question was about an elderly lady who needed a liver transplantation.
the actor was supposed to be the lady’s son, which gave me anxiety, but not as much anxiety as if the actor was pretending to be the elderly patient, because that happens sometimes and the cognitive dissonance of those benjamin button situations throws me off.
so i walk into the room and the guy immediately starts crying which means they have instructed him to cry in order to further emotionally destabilize me. “try to destabilize the student” is a legitimate bit of instruction they receive.
i will not be destabilized. i am as stable as an optic fiber internet connection in the silicon valley. my self esteem is as high as that of a businessman who decides to run for president. i can absolutely do this.
i am having a terrible time
i introduce myself and try to calm the guy down.
“My mother is sick, doctor, she’s going to die.”
that is a lie. his mother is probably fine. he is an actor. this awareness makes me upset. “I promise you we will give her the best care.”
i comfort him with the lines i memorized from what my upperclassmen told me of their previous tests. then he asks about the liver transplantations and how they are done.
“We will evaluate your mother through certain criteria and then place her in a queue for available livers. We’ll notify you when a donor shows up and we can do the next steps.”
the professor makes a tick. i can see him making a tick. this does very little to calm me.
“All transplantations are done through the public system, sir. There’s a single national queue, and the entire process is covered by universal healthcare.”
he asks me details about how the queue works. I explain to him about the CHILD and MELD scores. he asks more questions than a regular patient would, because he is an actor, and those questions are pre-determined. the professor makes ticks. i am trying to keep track of the five minutes of terrible time.
“I have money,” he insists. “I know that helps.”
i am very stressed with this situation. if he is insisting on saying he has money, it means i have not responded correctly to this point of the question. “It does help.” I say. “You can hire nurses to help you out at home, for instance! This kind of dedicated professional aid makes recovery a lot easier.”
the actor pauses and turns to the professor. the professor shrugs and makes a tick. the bell rings, giving me the extra corporeal experience of having my skeleton startled out of my body.
i absolutely fucking flunked this disgraceful question. this is fine. i can keep my cool for the next one. i am very good at keeping my cool under stress, and then breaking down twice as hard after, which is useful but not healthy.
i finish the test. i meet up with my friends to have our traditional post-OSCE smoothie. we look like we’ve just been through a series of harrowing psychological aggressions, which we have.
“Question three was about a heart attack,” my friend says, and I nod. “But I forgot to say the patient should not eat until further notice.”
i did not forget to say this bit of information, but it infuriates me because it is pointless. no one is going to feed a patient in the middle of a heart attack because we are busy trying to stop the heart attack.
“What about question four?” my other friend says. “The one with an actor. How did you guys respond to his attempt to bribe you into skipping the line for his mother?”
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