When some pre-med students think about becoming a doctor, they envision healing the sick, helping humanity, and maybe even the pay and prestige that come along with one of the noblest professions. But bedpans? And blood? And other bodily fluids that might make all but the strongest stomachs a bit queasy?
The everyday grotesqueness of medicine often doesn't sink in until they are given hands-on experience in the field -- usually after they have already spent years -- and countless dollars -- pursuing a medical career. So Santa Clara University is helping its students determine whether they're cut out for it early, long before they even enter medical school.
Pre-med students who land a much-coveted spot in a special university program shadow doctors, nurses, social workers, chaplains and business administrators at San Jose's O'Connor Hospital for the better part of an academic year. They see births. And deaths. They learn how to remove a catheter and burp a baby. They watch the calming bedside manner of chaplains during a patient's final hours, and discuss how hospitals can keep financially afloat when caring for many uninsured and under-insured patients.
''You see real life here,'' explained registered nurse Julie Friend to student Brandon Au on Tuesday, as they walked about the emergency room. Student Janet Ghilarducci spent much of her day Tuesday learning about hospital charts and the heart-rate monitors in the intensive care unit. The previous month, she had shadowed staff members in the neonatal intensive care unit. No matter what department students find themselves attached to, they are allowed to observe, but for liability reasons are not supposed to help. And they can opt not to watch something.
''There have been a couple of students who have stepped out of surgery,'' said Alice Doyle, the program's coordinator. Of the 43 students who have completed the program in the past four years, no one has fainted while on the rounds, she proudly reports. ''But they've felt a little weak in the knees.'' Ghilarducci, a mother of three, said she drew the line at watching how to change an adult patient's diaper, reasoning that she has already changed enough diapers.
Student Jacob Fuller found his time spent shadowing workers in the intensive care unit the hardest. ''It was a lot of death,'' he said. ''It was very hard to watch families go through that.'' Since the program's inception, one pre-med student has determined that medicine isn't for her. Others have decided that they would rather go into optometry or genetic testing -- health care professions that could keep them out of a hospital setting.
''What better time to recognize that, as a junior in college rather than a junior in medical school?'' said Margaret McLean, director of biotechnology and health care ethics at the university. McLean thought up the program after having watched some of her peers drop out of medic! al training midway through school. It was very painful for many of them to come to the realization that ''they loved people but they couldn't deal with sick people,'' McLean said. ''They just weren't cut out to be a physician.'' Just as Santa Clara's unusual program weeds out students who aren't suited for handling IVs or sutures, it can be affirming to those who are.
''When I started this year, I had my doubts. 'Maybe medicine isn't the thing for me,' '' said Ghilarducci, 52, who worked as a dressmaker before going back to school. ''But every single time I came to the hospital, I thought, 'Yes, this is it.' '' Students spend five hours a week at the hospital, logging more than 110 hours in at least five different hospital departments before their year is over. And they meet in a Santa Clara classroom every other week to discuss the ethics of patient care decisions that doctors and nurses face.
Competition for the slots is tough: The university turns down more applicants for the program than it accepts. And each earns college credit. But what they really walk away with is a newfound understanding of what goes on under the fluorescent lights of hospital wards.
''The stuff you see on TV is hyperdramatized'' -- viewers don't see nurses biding their time watching a patient's IV slowly dripping, Ghilarducci said. ''When you come to the hospital, crisis points come. But it's a lot of quiet care in the meantime.''