It was one of those days in medicine where you feel stretched beyond your elastic limit following a series of unforgiving weeks. We were tired in every way; our brains felt saturated and our feet hurt. It was during that blessed hour at the student lounge when we finally got to crash into bean bags and flop supine on couches, that we found ourselves thinking aloud:

“I think choosing medicine messed me up….”

“I’ve forgotten what it feels like to get up on the other side of a 5 hour sleep…”

“I don’t like old people! When will Pediatrics start??”

An approximate 6-7 years of living the jaded medical dream was starting to bring out the worst in M4 medics, drained off inspiration:

“I feel like everything that I studied over the past have leaked out and I can’t bring myself to start over….”

“I love this rotation but I wish I had more time!”

“Oh, why did I pass up on aeronautical engineering for this?”

And then it was my turn. I mirrored their physical state but my answer actually surprised me:

“I wish I were an RBC, or living inside one.”

The medic whose face was planted on the bean bag raised her head to shoot me a Parkinsonian. One paused to raise an eyebrow before resuming his cave man approach of wolfing down a sandwich. The others sported expressions that were a mix of apathetic, dumbfounded and amused. I continued:

“Imagine looking at the world from inside the safety of a little erythrocyte. Your palms flat against that flexible membrane; you are excited, having just been released from the bone marrow; the only world you ever knew. You get to watch platelets and WBCs swish past……and most exciting of all, you get into the heart!”

The looks now featured the apathetic, entertained and the worried. As I had unwittingly spilled my lancets all over the floor, I decided that I might as well continue:

“Imagine looking down from the right atrium at the tricuspid valve, as it opens and closes; a dynamic ‘Y’ shaped welcome….envision waiting for that comforting drop into the right ventricle, feeling the strong push into the pulmonary artery (don’t forget to appreciate the semilunar on the way!) and into the lungs, past the delicate alveoli and back into the heart which you were missing already. Imagine feeling fresh from all that oxygenation, your environment so much brighter and down you go again into the left ventricle while admiring the only valve with 2 cusps! And then, it literally feels like a roller coaster ride up the aorta, past another semilunar; you are dizzy with the idea of where you’d-“

“OoOokay, that is the weirdest thing I have ever heard anyone say!” interrupted the one whose eyes mimicked the clinical of Graves’.

SEM of a freeze fracture section through the lining of the colon, showing red blood cells (purple) inside the blood vessels of the lamina propria (green).

“Please continue!” urged the medic on the couch; eyes closed, OHCM bobbing gently on her abdomen, a smile playing with her lips.

By this time, I was wild with ideas on how my world would be if I were ‘RBC riding’ through a patient with infective endocarditis, or in the middle of a vaso-occlusive crisis or into the spleen of a patient with hereditary spherocytosis or-

Unfortunately, the lecturer arrived before I could toss malaria into the wildfire. I returned to the present but for a moment there, I felt as though I’d really been through the passage of life!

Conducto de Vida (Passage of Life)