Back to our regularly scheduled program, here is number 6 in the 10 Things series. Now that I have a whole, whopping 1 rotation under my belt I thought I’d share my top ten things I love about seeing patients. Sa far…
- Hearing and seeing the abnormal- in school we were taught to know what “mom” is. “Mom” is normal. You know everything about “mom”. “Mom” is the way the human body is supposed to be. When something is different with “mom” you immediately know something is wrong. Every exam I practiced on a classmate has been normal and not pathological, but seeing real patients means there is real pathology. I am actually hearing real atrial fibrillation and seeing enlarged adenoids, instead of just reading about it.
- Their stories- each patient has a complicated story of what got them to that point. Some visits are more simple than others, but no two cases of strep or heartburn are the same. You learn to listen for key words and subtle nuances that lead you to a diagnosis but it isn’t always cut and dry and though its frustrating, its much better than class 8-5.
- Kids- Pediatrics is still an option for me, but I don’t know if I could see kids all day everyday for the rest of my life. Still, whenever there’s a kid I get to go see, especially for a sick visit, I get really excited because they are so sad and vulnerable. They only want one thing- to feel better and its very gratifying that I get to have a small part in doing just that. They aren’t faking or lying or trying to get drugs, they just feel crappy and I can see it right on their face. If I can send them home with a medicine and a sucker to get them there, then I’m a happy girl.
- Reading articles- call me crazy but I much prefer a couple relevant 5 page articles every night as homework vs. listening to 17-20 hours of lecture a week ANY DAY!
- Families- I like when patients bring their spouse or kids or siblings into the room with them. Sometimes they have very different and helpful perspectives as to what is happening with the patient.
- Coming home- I love in the evenings when my roommates and I are all home and we swap stories about the day- in compliance with HIPAA of course! We talk about the cases we saw that day and what we learned and pimp each other on which antibiotics to use and what tests to order.
- Procedures- I have a lot easier time understanding when its time to remove a mole, when I actually see multiple kinds of which ones get removed. Medical education in the first two years a lot of times says “You’ll understand later when you need to be concerned.” And we are just kind of left looking at one picture example of a concerning mole. Same goes for a lot of different things, not just moles. Its a lot easier to know when vaginal discharge is concerning when you see (ahem, smell) concerning discharge.
- Talking- In the first two years of med school, we see standardized (acting) patients in front of an attending. If that wasn’t intimidating enough, you are also being graded by said patient and said attending. For me anyway, this is not conducive to a nice, easy, free-flowing conversation between a competent future doctor and their patient. For fear of saying something wrong, fumbling with the blood pressure cuff, or being awkward, I often ended up saying things wrong and awkwardly and dropping things in those scary exam rooms. Now, that I am with real patients, sometimes in the room by myself, I see that I have their attention. They are looking to me for the right questions and answers and guidance and I feel like I can rise up to that and say useful things sometimes.
- Being accidentally called doctor- Seriously who doesn’t love this pleasant mistake, that will soon be true.
- Learning- It won’t be much longer that I can fall back on “Hold on, let me ask my attending.” It is my entire job- in this season of life- to learn. To soak up every last thing. To watch every thing that every physician around me does and to determine what they are doing right and what could be improved. I ask the same questions of myself constantly- what am I doing right and what needs fixing. It is such a rare thing to only be asked that you learn. So I will learn every possible thing from every possible patient on every possible day. I’m trying to do just that, and to enjoy it too, because it won’t be too long from now that I will be called upon to just “know”.