How to prevent fainting (for the squeamish medical student)

by Leo    11 Comments    Posted under: Career, Medical Schools

During my A-levels, when a close friend of mine confided in me that he was thinking about applying for medical school but felt faint at the very sight of blood it got me thinking.

I was desperate to study medicine but hadn’t considered whether I too might be unsuitable because of similar fears.

During my work experience, aged 16, I had seen a huge facial tumour excision with a pedicled flap reconstruction. I remember having to sit down after feeling a little dizzy. Needles and other equipment associated with pain also made me a little uncomfortable. The desire to become a doctor was stronger then these concerns and I put them to one side hoping I’d get over them in time.

My friend ended up applying for a different course altogether and I’ve since lost touch with her but it seems obvious that there must be individuals in a similar position to my friend and I, and who worry about being too squeamish for a medical career.

In my experience this is, in most cases at least, an irrelevant concern.

Speaking for myself I found that I was indeed a little disturbed by certain horrible things in the early years at medical school. When I looked around me, many others were too.

On our very first day at medical school, the trauma team decided to lecture us on the most spectacular injuries they’d treated that year. It was supposed to be entertaining and informative. Once the close up photographs of facially injured patients with teeth sticking out of strange places began to appear, two students fainted and a few others had to leave the room.
All continued with the course and graduated five years later and one of them is today a successful general surgeon.

As time went on I became immune to all manner of seemingly squeamish sights and built up my resistance to almost anything over the years. I say almost anything, as there are still certain horrifying situations for me, listed later.

For anyone actually worried about this issue, the following is important:
Every single student that ever embarked on a medical career has felt horrified or faint on occasion. This is entirely normal even if many won’t admit it. If you are someone who can stand through a lengthy, painful or bloody procedure on day one at medical school (not that you’d ever be expected to), you’re probably not normal and you are probably unsuited to being a good doctor.
So now, to the main point of this argument. I think that the main difference between students is that whilst most manage to avoid making a fool of themselves, a few cannot help but faint publicly whenever the opportunity to do so presents itself.

I therefore gathered the following anti-fainting tips from various doctors across different specialities. They should help the novice avoid the major embarassment of fainting in front of a hundred fellow students in a lecture room, or collapsing mid-seizure into an open abdomen in theatre.

1. Maintain adequate fluid balance
As a medical student and as a junior doctor, you will be busy and you will neglect your own needs sometimes. If you are dry, you are more likely to drop your blood pressure and feel faint. Keep well hydrated. Your urine should be light in colour and high in volume. In summary, keep peeing and stay vertical.

2. Look after your blood glucose levels.
Thinking of missing breakfast before the weekly consultant ward round? You’ll have only yourself to blame if you later feel dizzy and sweaty when the ward round gets particularly smelly.

3. Increase venous return
This is a common technique, taught to me by one of my senior students during junior surgery attachment. The idea is to push blood out of reserve areas whilst standing, which means tensing your calves, thighs and buttocks (in that order). An alternative way of achieving the same thing is to rock a few degrees forwards and backwards on the balls of your feet. This is effective and very discrete.

4. Escape, avoid, run away.
There are times when the best way to remain standing is to look away from the offending scene, avoid a certain situation or failing that, to politely leave and sit down somewhere out of sight of your colleagues.

In summary, don’t worry if you are affected by this initially or are concerned that you might be. You will eventually grow out of it with increased exposure.

My own initial discomfort at the sight of blood or pain had disappeared by the time I was a fourth year medical student. There are however a few ugly things that can still upset me on a bad day:

1. Bad feet
You will at some point see very badly looked after feet. If concerned, try to avoid becoming too involved with diabetes or vascular surgery as I have.

2.Infected ulcers
As above.

3.Toenail removal
Long bloody operations where the patient exits theatre in a body bag are not the most fulfilling events but cannot, in my book at least, be compared to the removal of an infected, ingrowing toenail. Somehow watching one is worse than doing one.

4. Patients screaming in pain
Severe pain should not really be witnessed in hospital, as modern analgesic methods are sophisticated enough for most eventualities. Of course obstetrics is the obvious exception here, but I’m sure they too will exit the dark ages if and when a medical degree becomes a prerequisite for midwifery.

Sorry.