Medical Education, Compassion Fatigue, Wellness

The Hidden Curriculum

The school talks to us about "the hidden curriculum;"
The only subject they can't teach and only act as adminiculum.
When some of us realize that the shiny apple we have bitten is rotting at the core
And what we learn about ourselves is more than we've bargained for.


A patient with a stillborn (still waiting to be born)
Tests COVID positive and I'm not permitted to scrub and see this rare case through
I'm not the same person that I thought I knew
I'm more concerned with the opportunity cost
Than the whole new life that this patient has lost.

Another patient, much younger than me
Comes in with a tender, swollen knee

She's a champion athlete
Finally able to compete
After nearly a year since her MCL repair,

But we both worry it's another tear.

While I'm evaluated, I palpate patella,
Tendons, pulses, and lamella,
She’s gracious as I fumble through
But that was hours before she knew—

"A thorough history, a pertinent exam"
Writes my attending, but I feel a sham,
Imaging reveals a shattered bone
The next time she'll compete is now unknown
We give her time to process this result
And lamely wait for the ortho consult.

And yet I’m determined to find a way
To more often be the person that I was that day,
And twice a day 'til she was d/c'd
Every shift I'd check, every note I'd read
She wasn't my patient after her admission
I'm an EM student; she was in stable condition.
But I know what it's like to want something so much
And how tightly to our dreams we clutch.

We are all heroes but occasionally villains
Armed with our penems and penicillins
But exhausted by the journey that it took to get here
And tackling our own doubt, debt, and fear.

The hidden curriculum reveals the chasm between
What is ideal and real in the medical machine
But I was told "the more urgent the condition, the slower you should go"
Leave room for the human among everything you try to know.

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The Hidden Curriculum

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At some point along the pathway to becoming a physician - or a better physician - we must pause and ask ourselves, "What am I learning from the hidden curriculum?"