Family Medicine in Review

In short, I enjoyed playing a family med doctor more than I thought I would and more than I had hoped to. A lot of it is based on the friendliness of the doctors and staff, I'm sure. I made them all chocolate covered strawberries for my last day. 20 of them were gone by lunchtime so I guess they came out good. That day was definitely a confidence boost- my preceptor told me I did a great job for my first clerkship and one of the medical assistants said, "I'll miss you- you're awesome" :).

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Some highlights:

1. The crying patient...s. - Dealing with upset patients by using the generic phrases ("that must be hard for you", etc.) has seemed to actually work. At least it gave me something to say to let them get it out. 

The first time this happened, I was present for a doctor telling a patient that she most likely has kidney cancer. The patient also has dementia. She didn't break into tears because of the cancer, but because she was fixated on the idea that her daughters weren't listening to her complaints about tooth pain (that may or may not exist). The doctor talked to the daughters in the hall while I sat with the crying patient, flailing in my search for comforting words. I stuck with a touch of the hand and silence. 

The second time, the list said "followup hypertension", so I was all ready with my questions, and then the patient tells me her father died a couple months ago and her best friend died 2 days ago and then proceeded to cry. Deer in the headlights!! --> Kim (I apparently got a high rating on empathy and concern for patients because of this encounter, since I handled an unexpected difficult situation.)

2. Someone I knew from college ended up as one of my patients... that was weird and slightly uncomfortable. Did not expect that one. And it was a complicated case, so now I feel bad and want to figure it out! 

3. Deeeeeeep breaths. - We did a lot of counseling on smoking cessation. One patient was being particularly difficult since he didn't see the problem with his few cigarettes/day stress habit. The doctor I was with proceeded to lead him... and me... in a breathing exercise. 10 slow deep breaths with eyes closed. One of the longest couple minutes of my life as I awkwardly leaned against the sink watching. 

4. No Lyme :( - I was really hoping to see a bullseye Lyme rash, but I didn't. I did see erythema multiforme, which looked like the patient swam in a tank of ticks... No idea what caused it.

(similar to this)

5. Culture shock - One of our patients was an Egyptian woman wearing a burqa, or some variation of it. She was totally covered except for a slit for her eyes. She wanted only females in the room, but when it was just us girls, she was ready to take off everything and put on a normal gown. So it ended up being a normal patient exam after all :)

6. Oww? - Got to watch an IUD get placed. It may be one of the best forms of birth control for many women, but eesh! Poor cervix. 

7. Two meningitis shots and 1 TB test later, I can now wield most kinds of needles! (poor kids...)