The story of how I fell in love with medicine. Truly.

At the end of August last year, I was fine. I had finished my internship, passed all the exams, “STEPs”, enrolled in the postgraduate studies course, perfectly spent one and a half months of holidays and was preparing to start work at the department and to write my PhD work. There remained only a few days of the summer which I expected to spend with a minimum of efficiency, and here I was called by my scientific research advisor, Professor Elena Yakymenko, and told me that the vice-rector for international work of our university, Professor Valeria Hennadiivna Marichereda offered to undergo a six-month internship in a cardiology clinic in Kaunas, Lithuania. The director of the clinic and, also, the rector of Kaunas University of Medicine, Professor Remigijus Jaliūnas, received the honorary professor of our university and, being in a new status, offered to teach two best graduates of ONMedU for a year according to European cardiology standards. And they, accordingly, recognized me as worthy to represent our renowned university in another country.
Of course, such proposals are not rejected. However, just after a wave of euphoria, there was a fear: can I adequately show myself there? Will my knowledge be enough? Can I really know how much I really can? Yes, I went through my internship, but I still had quite few practical skills.
Further conversation with Valeria Hennadiivna did not add to the optimism: she warned that if the director of the Lithuanian clinic saw that I was not zealous enough, then he would send me home a week later. Imagination drew a picture how I get to the clinic, they lead me, supposedly, to the resuscitation ward, show a patient, I look through the analyzes, I do not understand anything, the crowd of Lithuanians kindly looks at me, and I fly back with the next flight, ashamed from head to toes.
In general, I had three weeks left, during which I did not put down textbooks, I recollected the basics of practical skills at the department every day and set up seemingly elementary questions, because suddenly I had doubts about everything I knew. To top it off, a few days before departure, I was diagnosed with pneumonia, the temperature jumped to thirty-eight. However, as if I were not clinging to the salvific idea of a valid reason not to go anywhere, deep down I realized that staying at home would be even more a shame than not recognizing a heart attack on an ECG. Therefore, I swallowed the tablets and went to Lithuania with a firm intention to justify the hopes placed on me.
In fact, everything turned out to be a bit easier. Nobody was going to try me right after arrival. The internship format envisaged three months of training at the department of echocardiography and three months in cardiological resuscitation. The most important factor that reassured me was the sudden realization that my level of knowledge was not worse than that of the local residents (the residencyship is a European analogue of internship, which also has different lengths, depending on the specialization.) Cardiological residents in Lithuania, for example, study for four years while in other European countries – five). It was nice when I could answer the questions of a teacher who put the Lithuanian graduates in a dead end. Once again I felt gratitude to my teachers who spent so much time over the years as well as pride for the university. By the way, our ONMedU in Lithuania is known and respected.
A few words about studying in the residencyship. The first two years almost completely repeat our internship: the same alternation of full-time and part-time forms, cycles, lectures, seminars. The next two years are almost a full-fledged work of a doctor, with the sole exception of the fact that they are not responsible for anything. Residents are in reception, doing different procedures, starting with echo and veloergometry, ending with the installation of stents. It depends on the cycle in which department they pass. The cycle lasts for exactly a month, while in the next office there is always a more experienced doctor, always ready to come to help.
As for me, I came to the clinic at 8.30 every day, took part in five-minute meetings, watched the results of various instrumental studies brought out by the projector, tried to get into the Lithuanian language. It turned out to be quite hard, so there was always a resident with me, with whom we became good friends, and translated everything into English. I can only imagine how she hated me during these six months. Yes, all studying and communication in Lithuania was in English, it is known by most doctors and absolutely all young people there. At ten o’clock, echocardiography was started in the office (there are exactly ten of these rooms, and echo machines are in the intensive care unit and the interventional cardiology unit). There were always a few residents in our office, me, a nurse and professor Vashkelite. The procedure was performed by a resident, the professor or a more experienced resident joined occasionally. Two weeks later, the professor began to entrust me first search of species, and two more later – measuring all the required sizes and indicators. In fact, a month after arriving in Lithuania, I began to examine Lithuanian patients and write down conclusions, which then, of course, were checked by the professor while translating them into Lithuanian. The subject of my special pride is that, at the end of the three-month term in the echo, I was left at the reception alone, and the translator’s function taken by a nurse in those cases where the patient did not understand any of the languages known to me.
After the reception there were seminars, where the professor taught the theory and arranged a survey. Yes, an important clarification, professor Vashkelite has myopathy, arms do not function above the hands, she moves in the wheelchair. She has had this condition since an early age and entered the university with a ready diagnosis. However, she became a doctor, a professor, learned to do echo which with such physical limitations is unlikely to be simple, and her technique was objectively at the best level among all the specialists of the clinic. If I ever need to tell a story about the outstanding strength of spirit, I’ll tell about professor Vashkelite.
And after dinner and until the evening, till 7-8p.m., I looked for patients in different departments I improved the technique of echocardiography. Several hours, day after day, I did everything to master the skill, sometimes on Saturdays. And this was really a true decision, which later helped to get the desired result. Carefulness is something that I often lacked during my studies in Odessa, in a foreign country, I had lots of it.
The first three months passed promptly, and shortly after the New Year, I switched to cardiological resuscitation. It was all different. From the obligatory duties – daily round, the rest of the time I had to wait for new patients or any other emergency. I actively communicated with doctors about appointments, studied the history of diseases, interviewed patients who were able to speak. From the other things I was entrusted with was doing an electrical cardioversion, taking blood from the artery. A couple of times I did an indirect heart massage. In the remaining time, I continued to do echo.
Intensive Care Unit is perhaps the only place in the clinic, where the role of residents is minimized, and I, being an alien, received even less. However, it was also a wonderful and interesting time, during which I learned the mass of the new things, and also realized how great the work of the doctor is. In Odessa, I did not have so much chance to be in intensive care units, so I did not really realize how immense the responsibility of an intensive care unit staff is. It was one of the most important “insights” for the whole trip.
I did not have much spare time, I spent it on textbooks, gym, walks in the city – thanks to the resident guys who arranged a guided tour of Kaunas for me. Due to all this, the homesickness was not so sharp, although at the end of the internship I felt it more and more often.
At first the six months seemed to be a significant term, and it turned out to be so. But it was an incredibly useful time, at the same time the most difficult and most sophisticated in terms of learning for all my life. From the very beginning, all the people I chatted with seemed to have just a desire to give me some help. I am very grateful to my teachers, doctors, rector and administration of the clinic. Yes, it was difficult, but solely because of the amount of information that was absorbed.
Now, a few weeks after my return, I can say that the trip to the internship in Lithuania was the main event in my professional life. I admit, I used to look at medicine with a share of skepticism. Probably the main reason was that for me it was in a sense a routine, something routine and completely devoid of bright components. The traineeship, the fears that preceded it, moments of joy, sometimes stress, everyday examples of courage and struggle with myself in order to achieve the great goal – all this filled the word “medicine” with a powerful, extremely emotional and in its own triumphal sense.
I am really grateful to Professor Maricherida for this truly unique opportunity and to my supervisor and mentor, Professor Yakimenko, for recognizing me worthy of this opportunity. I’m proud to say that our university was well represented on the international scene.
In conclusion, I want to wish my colleagues, students, interns and doctors to never stop learning, and also more often remind myself that we are engaged in the most important and worthwhile business on the Earth.
Volodynyr Savitskii, post-graduate student