Saturday, November 14, 2009

Push On Through

It's been a long week. But then again, I'm kind of used to this - in fact, it's a recurrent theme.

This week was Block 3 exams - thorax and abdomen. Anatomy and human development (devo) were both quite easy and I did really well in both of them. Then again, Block 3 was supposed to be the easiest block of exams and everyone's expected to do really well. However, biochem is as difficult as always. It seems that no matter how much or how hard I study, I just can't get the grade I want in that class. Grrr. I've determined that I suck at neuro and biochem. Block 4 is on the pelvis and lower extremities. Joy.
Soon after my last exam (biochem), which was on Friday the 13th (how apt), I went to my mentor's office to shadow him. All M1s are assigned a mentor who we visit in their clinics. Mine's a pediatrician - he's a really nice old guy. I got to his office a bit before lunch and there was lunch provided for everyone in the clinic. It was a really nice clinic! His son actually joined his practice soon after finishing residency; I found that interesting (I don't think I'd ever be able to work for/with my dad).

After lunch he had some charts and patient notes to finish writing up, as well as phone calls to make. He gave me some things of his to read and look through - to "inspire" me about pediatrics I guess. Before we began he had talked to me about his philosophy of medicine, and I could see that played out in practice. He gave me some great advice which I'm sure will be of use to me later. He's a super-organized guy, which is of course a great quality for a doctor to possess. He's also close to retiring and doesn't really know how to use computers, and so laments the EMR (electronic medical records) system Obama advocates. I held my tongue, lol. Generation gap - typing is second nature to me whereas it isn't for him.

Starting at 1pm, we saw patients. In the span of just under 3 hours, we probably saw 10-12 patients (rough guestimate) - that's a lot, btw. He was almost sprinting (or as close as a 63-year-old gets to sprinting) from exam room to exam room. His poor nurse couldn't quite keep up with him, lol. There were a lot of well-child physical check-ups. I saw this really cute baby girl. She didn't like the tongue depressor and so bawled when the doctor tried to look in her mouth. The office visits were pretty typical and routine - "bread and butter pediatrics" as he called it.

He counseled a lot of parents to get the seasonal flu and the H1N1 flu vaccinations for their kids. It was quite interesting seeing the parents' different reactions to it - some were for it, some were against it, most were on the fence. At times it almost seemed like he was pushing a bit too hard to get kids vaccinated, though I understand his viewpoint - he's had several young patients hospitalized within the last 2 months due to H1N1. He doesn't agree with the way the government is handling the vaccination distribution (that is, they're doing all of it), and I'm inclined to agree.

Two of his patients were from "second generation" families, meaning that the pediatrician used to treat the parents way back in the day. I thought that was really cool - that you would love and trust your pediatrician so much that when you had kids of your own you'd take them to see the pediatrician you used to see. That in and of itself speaks volumes about him. He even has one or two "third generation" families, where he once treated the grandma/grandpa!

All in all it was a great experience. Though this first visit was pretty much exclusively shadowing, he said in the next 5 (mandatory) visits he'll show me how to use some of the typical equipment - otoscope, stethoscope, etc - so I can actually do something and do some things on my own. I look forward to that! I was exhausted when I got back to my apartment, and then I went with my roommate to join up with some friends to play poker. I lost, but I got damn close to winning this time!
This morning (Saturday) I went to volunteer again at the free clinic for the uninsured. Unlike the first time I was there, I didn't have an M2 with me. So I saw patients and took their medical histories all by myself. I also took the first guy's blood pressure manually (because electronic blood pressure cuffs SUCK). I was somewhat off from the number the M3 got when she entered in with me later. Oh well, at least my measurement was still WAY more accurate than the machine's.

As an M1, I feel woefully ill-equipped to do much beyond just talking to the patients. The M3s kept asking me if I did a physical on the patients and I was like, "No, I haven't learned that yet - won't learn that until next year." I was pulling the "ignorance card" left and right, lol. I did get a little better at presenting the patients to the attending compared to last time (at least they didn't look annoyed at me), and I took more thorough histories than last time as well (I think).
Okay, I'm exhausted now for reals. I think I'm just going to crash for the remainder of this weekend, lol. Thanksgiving does not come soon enough - I'm excited to go home. :-)


Anonymous said...

I hear a lot of exhaustion in this post (obviously), but I also hear that you are keeping very busy, and it seems you are reacting well to that. I hope you are feeling more useful and able and capable as things move on. It's evident you're definitely in the right field for you, and that should give you confidence.

Pilgrim said...

You start to sound like "Grey´s Anatomy"!*lol* Have a nice vacation time. :-) Propz Pilgrim

Jacob said...


Sorry, I can't think of anything specific from your post to comment on. But being the social phobe that I am, I often becomg awkwardly reticent.

It's nice reading about other people's lives and sort of experience what they are going through vicariously.

Anonymous said...

oh! the Thorax was one of my favorite books growing up... no, wait ... Lorax... whatever....

(ok bad Dr Seuss joke but you sounded exhausted so maybe a laugh will do you some good ... or just a groan since the joke was so bad)