The fourth trimester

Ally Gallagher, M.D. Class of 2020
Ally Gallagher, M.D. Class of 2020

After 40 plus weeks of laborious (pun intended) and miraculous work, a baby is born into the world. It is a long-awaited joyous day. For months, friends and family help prepare for the new addition. The nursery is arranged, clothes laundered, stuffed animals lined in a row, all ready for this little person to arrive. But after delivery, it is ironically the babies themselves who are not so ready for this new beginning.

Lo and behold, “the fourth trimester:” a name assigned to the first 13 weeks of a baby’s life. It is a period of great change and rapid development as a newborn adjusts to life outside the womb. Before birth, newborns have known a world very different than ours. One that is dark, warm and filled with muffled noise. One in which they are constantly held, fed and coddled. The transition earth-side is wrought with frightful stimuli. The lights, the sounds, the air! Newborns are forced to adapt to uncertainty and cope with insecurity as they learn to thrive in a new world.

As I began medical school with a three-week-old daughter (crazy, I know!), the irony was not lost on me that just as she was adapting to a new world, so was I. The white coat ceremony was a birth of sorts. Just as my daughter Sadie’s clothes hung in anticipation in her closet, our pressed coats waited for us as first years. On the day of our ceremony, we were welcomed into the world of medicine by OHSU faculty and alumni. Our families and friends celebrated and applauded this monumental milestone. While it was an exciting day, it also marked the start of a frankly frightening transition.

During the first weeks of medical school, I felt very much like my newborn daughter. I had crossed a threshold into a new world that was both hyper-stimulating and intimidating. During orientation, fourth-year medical students warned that previous study habits would fail us. They spoke of the unprecedented workload, and the difference between what we had come to expect in undergraduate education compared to the lofty expectations of our medical school curriculum. They were right. The strategies I had long relied upon were no longer sufficient to succeed. I was constantly challenged to adapt to each week’s material, switching between study guides, concept maps and videos. I sought any tool that would help me synthesize the hundreds of slides I was responsible for learning each week. Just as my daughter struggled to see farther than 12 inches in front of her, the first weeks of medical school left me feeling blurry-eyed with narrow perspective.

However, just as babies rapidly develop and progress, so did I. By month two, I began to see a little more clearly. I found my stride synthesizing material and gained confidence speaking with standardized patients during clinical assessments. I found myself no longer surviving but actually beginning to thrive. In Sadie’s second month of life, she delighted us with her smile. A sure sign that she was learning to interact with the world around her as opposed to simply being a fixture within it. That is precisely how I began to feel as the weeks within our first block progressed. Insecurity about my new surroundings gave way to active engagement in this world I had joined. As the fourth trimester comes to a close for both Sadie and me, we have made great strides, but also look forward to many exciting and challenging times ahead of us — learning immunology and rolling over, to name a few.

2 responses to “The fourth trimester

  1. I find so much hope in your post. And it is so encouraging. I am a pre med student and beginning to look at medical schools. I have a 2 year old son and have been ambushed by negativity and “you can’t be a parent and become a doctor”. I am glad to know that there are others in the same position as me and are thriving! Congratulations and good luck.

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