Thursday, November 29, 2007

Humble Cake (it is not)



I know the person least suitable for explaining traits of one's personality is one self. At least you can hardly call it objective. So then, let me put it this way: I think people I know would call me reasonable. I'm not one to make hasty decisions (unless of course they need deciding NOW-NOW-NOW), I'm not one to jump at conclusions, I'm not one to get myself into things without having thought them through, I'm not one to let my emotions get the better of my judgement. I occasionally get the odd idea of something outragous, but I usually have enough common sense to stop myself in my tracks. Usually.

Except for this Monday. This Monday, I stormed out of a doctor's consultation, a consultation in which I was supposed to be merely an observer. Or, at least, so I thought. Turned out the good doctor had an idea of running me over with through an anatomical review of the eye socket. Actually, he thought I was the one supposed to give the lecture. Unfortunately, it's just shy of four years since I read up on that subject.

To my defense, I'd briefly, during my morning train ride, glanced at the chapter in the book about the patient group I was to see that day. And yes, a few of the diseases within the group will sometimes have symptoms from their eyes, but it is, I have since learned, not very many. I'm all for deducting symptoms from the knowledge you have of anatomy, physiology, bio-chemistry and pathology, rather than just learning symptoms and categories by heart. But you just can't know everything about everything, in detail, all the time. At least I can't.

I guess I just ticked the man off from the beginning. And I'm not quite sure what I did, but if I'd gone with my gut feeling from when I entered his office, I should've turned around and run, RUN, 'cause that's what I felt like after just a few seconds. For some reason I stayed. When the patient arrived, the doctor didn't introduce me. Which isn't necessarily an unexpected event in the life of a medical student in a hospital. So I introduced myself - afterall, it feels more right to have done so when you're about to sit in on a private conversation between a patient and his/her doctor. If I was the patient, I'd like to know the name of the persons in the room, no matter the reason they're there, or how many pledges of confidentiality they may have sworn.

On it went, and for some reason, the conversation turned into this overhearing of me and my knowledge of the beforementioned eye sockets, synovial membranes, and their likeness with hand brakes for bikes. Because this is a comparison that is often used. Or not.

Regardless. He kept asking the kind of questions were you know the person asking it has a very specific answer he wants, but you really aren't quite sure what he asked in the first place. And he looks at you over the rim of his glasses, expecting you to not be able to answer. So you try an answer, just to see if you're in the ballpark, and if you're lucky, you're right. And I was, lucky, a couple of times. But not much wiser, 'cause I wasn't sure what question I'd answered. In the end, when there was no more guessing to be done, he answered his own question. Maybe with a little scorn in his voice. Glad it seemed to be over, I mumbled "Oh, yes, that's right!" because I actually, faintly, remembered the existence of the structure he just mentioned.

This went over a couple of times. For the third time, I answered "I don't know". I looked down into the floor, tears welling up in my eyes, my throat turning into a knot. And by the way, why is it that when I get really, REALLY mad, I can't seem to stop myself from tearing up and growing hoarse and just generally not look or sound like a very intelligent woman?

His attention turned back to the patient for a second and I thought: You know, Zarah. You have two choices. 1, you wait this out, keep answering yes and no and I don't know, with the risk of you starting to cry, right here, in front of the patients and him. And then tell him afterwards that he's a bastard and that when he heard the second "I don't know", heck, when he saw the third, fourth or fifth quizzical look on your face, because you didn't even know what he was asking, he could have caught up on the fact that he was WAY beyond the scope of your pretty basic knowledge, and he could've stopped. You could tell him that this is no way to educate anyone, and for that matter, not a way of conducting a consultation. I don't know much about teaching (or conducting a doctor's consultation for that matter) but I'm pretty sure humiliating people ain't the way to go by it.

Or, 2, you can get up and walk out of here. This isn't the first time you hear about these situations. You'd never imagined yourself to be in one, but hey, here you are. You have to stand up for yourself, because it's becoming more and more obvious, during the time you've spent in the hospitals, that noone else is going to do it. Ever. You could let this guy continue, and you could put up with it, and you could feel even more humiliated than you do now. And you can be sure that somewhere along the way, there will be more people like him. And some day, you're going to have been walked over by so many people you no longer know who you are. Or you can say stop, and stick with what you believe in. That you're good enough, and that no man and his twisted view of the world should tell you otherwise.

So I got up, just as he was about to turn his attention back to me and I said: "I think I'll say thank you for now" and he was all "Why?". I pointed (I actually did - that wasn't very polite, but I had to strengthen myself somehow) towards him, saying "because you have no right to behave like you do". And left. Storming down the hall, tears starting to trickle down my cheeks.

I was furious. I was MAD. No, I didn't know the answers to his questions (later, my co-students has assured me they wouldn't have known the answers either), I had no idea what he was asking me, but I tried answering, initially, at least. I tried to seem interested and wanting to learn.

Yes, I am a poor little medical student. Feel sorry for me. Ya-dah ya-dah. But the irony is that that is exactly the feeling I've had the last couple of months. Poor me. I hate this. I don't like hospitals. People smell there. The doctor's are stupid. We, the students, have to fight like cats and dogs to get in on the operations, the ward rounds, the consultations, to get to see patients. And get nothing but ignorance from the senior doctors. Medical students - oh, they're here again, are they? No, no, I'm not doing anything interesting today - you better go find someone else. Well, you're the only one left, dude. It's a struggle, and I mean that very litterally - to actually get the chance to learn.

That's how I used to feel. But last Monday, I didn't feel like that. That day, I was looking forward to getting some questions answered, I was actually interested, and not just pretending to be. I was actually willing to fight for some knowledge. And then this was what I got.

I know it's a privilige to have the opportunity to learn. I know I'm lucky. But darn it, sometimes, it sure doesn't feel like it. Sometimes, it feels like the only thing you get is a slap in the face. Wanting to learn and actually acquiring it seems miles apart in this field. It's a minefield, and one where you're sure to get yourself hurt, stepped on and humiliated, it seems.

So if you're wondering why I'm questioning my whole carreer choice, this is just one of a whole lot of reasons. And pardon me for loading of here - at least now I have more room for cake. Not of the really humble kind, though - I have to hold my head high, at least in some aspects of my life ;)

Pear-Marzipan Cake - an adaptation of Maria's Pear Cake from Nigella.com

250 grams unsalted butter
100 g. soft brown sugar
200 g. sugar
4 eggs
300 grams flour
pinch each of ground cardamom, ginger and grated nutmeg
2 teaspoons baking powder
4 tablespoons milk (or cream)
100 g. grated marzipan
2-6 pears, depending on size and personal taste (I used 4 largish ones)
demerera sugar (for sprinkling on top)

Butter and sugar-dust a spring form cake pan, 24-cm. in diameter. Preheat the oven to 180 degrees celsius. Cream the butter with the sugars. Add the eggs, one by one, beating well after each addition.

Sift together the flour, spices and baking powder. Fold this into the batter, alternately with the milk. Lastly, fold in the grated marzipan. Spoon half the batter into the cake pan.

Peel and core the pears, and cut half into chunks. Spread the chunks on the batter. Top with the rest of the batter, then lay out slices of pears in a nice pattern (or just cut the rest of the pears into chunks too, and sprinkle on top - all up to you!) Sprinkle the whole thing with a nice layer of demerara sugar. Bake for 40 minutes to one hour, or until a cake tester comes out clean. The total baking time will depend on how many pears you've used - mine took closer to one hour than 40 minutes.

Serve with crême fraïche or vanilla ice cream - or as suggested in the original recipe, with caramel ice cream. The cake keeps - and actually improves, I think - after a couple of days on the counter, so this is one to make in advance, if need be.

4 comments:

Anonymous said...

Hey! I want to congratulate you for standing up for yourself!! I am also a medical student (3rd yr) and sometimes enjoy cooking at home much more than being degraded as a student (masked as 'teaching') when I'm at the hospital. But don't doubt yourself or your career choice. Just always remember not to treat people that way when you finally become a doctor. (PS I cried at the end of a surgery when the resident yelled at me for not cutting the stitch as carefully as I should have, and this was after 10 weeks of training and greater than 20 years of experience of using scissors ;-)

Jennie said...

Oh Zarah-pigen. It's nice to feel human once in awhile, but preferably without the shame of feeling it in front of the likes of that bastard. Fantastic that you left him in your dust, with a patient no less!

And as long as you keep leaving words like "epithelia" on my blog, you'll always be my medical hero. Next to George Clooney and Dr. House ;-)

Deborah said...

I know nothing about being a medical student - I have a feeling my graduate program (library school) was the exact opposite of everything you do. Mistakes were welcomed and differing opinions openly solicited. So I applaud you for continuing in a program that you know will hold more of the same.
But you know, if it keeps inspiring recipes like this one...I hope you have one or two bad days a year. :)

Aileen said...

Hi Zarah - I have long enjoyed reading your site, but don't think I ever commented. Today I'll change that. I don't know much about becoming a doctor - other than it is tough and I have so much admiration for it. But I do know about going to grad school, and realizing that may have just entered into a field that is not the best fit. I actually enjoyed lawschool. But then lawyering....well, umm...ugh. I eeked out 4 years in one of those mammoth Manhattan-based law firm, suffering more humiliation and actual wretchedness than I would ever have imagined. It took me that long to find the courage that you found in that doctor's office. Good for you! By the time I realized that I could actually leave, I had only a shred of soul left. Fortunately, I also had just enough gumption to invest it all into a sudden, random move to Alaska. And while I still have more than the occassional day of wishing I could be a professional pickler of turnips, or some other income-source that allowed me to nurture a herd of goats rather than a pile of caselaw praising that ridiculous and personality-poor "reasonable man", I have found myself practicing law in a way that doesn't embalm my soul. Some days I even do things that make the whole New York experience one of the best things I ever did. It's really quite remarkable, actually. So hang in there! My guess is that you will find yourself the niche that fits - and you will be more likely to recognize this fit by all the memories of all the contrary experiences you had to wade through to get there.

And, by the way, last night I made the cauliflower soup I believe you posted oh! so! long! ago. And it wasn't the first time. It's kind of a regular thing in our hovel on stilts at the other end of beyond. So thankyou! So glad to see that you will be posting every day!