Friday, October 23, 2009

"You made me feel so comfortable. Thank you"

With 8 weeks of medical training, there is little I can actually do in a medical setting aside from tell patients about mitosis and perhaps their musculature from my cadaver labs. Nonetheless, I've already (and thankfully) have already been exposed to several afternoons working with patients in medical offices.

An interesting experience happened on one of my first visits. My school's worked hard to drill the importance of active listening and the tools for gentle interrogation of patients - "no leading questions!", "probe deeper!", "80% of communication is non-verbal!" etc. etc. Even so early in my medical career, these skills have proven invaluable.

Setting: Medical office, my first office visit
Characters: me, my partner, and a patient (40ish y/o female w/ ummm, well her pants off)

Me: So Ms. X, tell me about yourself.

Ms. X: (apprehensively) What'd you like to know?

Partner: Just tell us about your life and who you are.

Ms. X: Well, I work for the city of ___________ as a street flagger and i'm ___ years old. I have two kids and am single.

*Conversation continues for 10 minutes with no reference to why her pants are off*

Me: So what can we do for you today? (ready for her to explain the pants situation)

Ms. X: Well, ummm. I errrrr...I think I may have an ingrown toe nail.

Me: (nonchalantly) Oh, ok tell me about that while I have a look (i am now kneeling in front of her - yes, pants are still off).

*Conversation continues*

Partner: Ok, is there any other reason why you're here today?

Ms. X: Well, ummm. Yes. I uhhhh. I actually need a refill for my asthma prescription.

Me: Errrrr right. Sure I'll make sure the doctor deals with that. (silent moment)

*Conversation continues and my partner and I start asking deeper questions about her history and validate and normalize her concerns about her sexual history*

Me: So ummm...anything else?

Ms. X: Yes, actually I'm concerned I have herpes.

*My thoughts: Did I just manage to convince a woman I just met to tell me her deepest and possibly most sensitive concerns?"

*Conversation continues and we learn more about her life and everything that's led up to this point. Doctor comes in and prepares to examine her genitals*.

Me: Would you like us to leave?

Ms. X: Of course not! You made me feel so comfortable. Thank you!

Scene. I'll save you the details of the exam.


So sure, it's only been 8 weeks. But I think I've already learned one of the most important skills a doctor can ever possess - listening w/o judgement. Now the challenge is

Saturday, October 3, 2009

High-School and Medicine

Here's a little known fact about medical school: it's EXACTLY like high-school. Well, alright, maybe not completely, but the two are strikingly similar.

Here goes:

1. Late? Run to class!!! No, seriously. I've been in med school for one month and can't count the number of times I've done this at 7:58am. Imagine a goofy knapsack (clinging and clanging of textbooks and recess munchies) slung over my shoulders, breakfast stuck on my shirt, and me darting with flipflops whilst dodging freshmen, puddles, and homeless people to make sure I don't lose marks for being late.

2. The administration is holding my hand again. The office ladies are nice and take care of everything. Everything.

3. Lockers: This is actually better than high-school 'cause I get not one, but TWO of them (except one holds my clothes with bits of cadaver on it for anatomy labs). Like an 8th grader, I'm still having trouble opening the lock on my lockers. On the plus side, the lockers are too small for me to fit in finally.

4. Locker room issues: Ok, so the high-school I went to was packed with dudes who thought they were big buff guys ("thought"). 6 years out of high-school, I've outgrown many of them and sometimes question why on earth I felt self-conscious as the tiny kid. Well, changing in the locker rooms before anatomy labs brings it allllll back (but with nicer people). I'm quite certain that having pecs the size of Pamela's assets and a washboard stomach were pre-requisites of med-school. It doesn't help that I have several firemen in my class. They make me feel fat.

5. I'm singing again. Wow, I'm really painting a dorky picture of myself now. Yes, I was in the high-school choir (and damn good at it!). And am now part of a men's a cappella group. If this whole doctor thing falls through, I'm ready for something bigger and better. Like being a castrato.

6. Girls are :)! I remember a time when girls in high-school (crazy as they were) actually really made an effort to look pretty. Maybe it was the whole 90210 thing/Kelly Kapowski influence. Anyway, come undergrad and I was vortexed into a world of feminine blahness. Gum boots and parkas?! They might as well have thrown moccasins and beaver hats into the mix. Having to see patients and do clinical skills regularly, the ladies look.....well attractive again. It's nice not having to imagine what they might look like sans eye cruds and sweatpants.

7. Lunch time, recess, and playgrounds. So maybe we don't call it recess, but a 10 minute break in between class is the way to go. And 12:00pm everyday - lunch hour! Pool tables, fooseballs and a gaming console that doesn't work (makes me nostalgic of the inner city school I went to).

8. Student Council! No, I didn't get suckered into this one. But someone actually campaigned by bribing us with bon bons.

9. School camp! Remember packing your snackpacks and sleeping bags for that annual school camp? Well, that was just a few weekends ago. Campfires? Check. Marshmallows? Check. Keggers? Yup - sounds like high-school. Here's a new one though: being told by camp organizers to never post some photos (that I best not talk about here) on the net to protect our colleagues' careers.

10. Failed a class? That's ok. Sorry to let you in on this secret, but medical school really really really wants us to pass. I better stop here.