So last week Thursday, I slept through four alarms and found myself almost an hour later to my "Practice of Medicine" class...something we GW med students like to call the "touchy-feely side of medicine". So I snuck in late and as my small group wrapped up the discussion, my physician mentor called upon the late person (me) to do the first standardized patient interview. These are actors who get paid by the med school to act out as patients in a clinical setting. I did read the required readings, but completely missed the discussion on who my first patient was going to be. However, I found out really fast just what I was in store for. Needless to say, there was a vomit of mistakes as I fumbled through one of the most uncomfortable exercises I have had thus far in medical school.
My "patient" was a 17 year-old female who came into the clinic for her first woman's wellness exam because of complaints of vaginal itching and redness. Her mother accompanied her, explaining that her daughter had something "not sexually-related going on down there". Of course, me being me and because I missed the discussion, I outright asked the "Are you sexually active?" question right after the young patient described her symptoms of itchiness and redness on her vagina.
First, I must commend the actress who played the part of the controlling-but-yet-forgivable-because-her-duaghter-is-17 mother because she did her job well. By the time I was done interviewing (miserably) and was able to successfully kick out the mother from the examining room so that I can get the "real" answers from my fake patient, I was sweating profusely and completely exhausted. I was exhausted because I really didn't know what part I had to play here. If I was really a physician in this scenario, it would have been a lot easier to explain to the mother that her daughter is almost an adult and that regardless of whether she was sexually active or not, she is on the cusp of becoming an adult and needs to be treated as one now. But, I understand how hard this would be for any parent to do...letting their kids become independent individuals. It's a tough decision, which is why I stumbled shamefully all over myself in this interview.
Anyways...this whole scenario wasn't the point of this blog. Today, I took a full history for a new obstetrics patient for my physician mentor. The patient is a 19 year old who was accompanied by her mother and the father of the baby, who is also 19 years old. I knocked on the examination room door and walked into this crowded room and just prayed that this mother would not be like last week's mother. Oh my goodness...because if that was the case, I really don't think I would get through the million questions I had to ask from every new OB patient. Luckily, the mother was silent (she was texting in her iphone the whole time) throughout the whole questioning except for once when she piped up to the FOB (father of baby) that he needed to answer my genetics questions as well. She wasn't really paying attention to the fact that I was asking him the questions as well and he responded to my questions by shaking or nodding his head. Although this interview was nowhere near as uncomfortable as last week's fake scenario, it was still a little weird to be asking all these personal questions from my patient with two other people in the room.
So I successfully got through asking all the questions, including when she thought her last menstrual period was and calculated how far along she was in her pregnancy (about 10 weeks according to the wheel). I then left the room and presented my patient to my physician and we entered the room to do the physical exam, pelvic exam, and pap smear (which I did...yay!). Low and behold, home girl was off in her date by two months! We felt the size of her uterus and approximated her pregnancy to be closer to 18 weeks instead of 10 weeks. Now this news wasn't received very well by our patient. She seemed very sure that her last period was 10 weeks ago. The only one smiling was the "father of the baby"...who was happy by the news maybe because he has some information the rest of us did not have...
Now this drama... my class and readings did NOT cover.
Showing posts with label Medical School second semester. Show all posts
Showing posts with label Medical School second semester. Show all posts
Thursday, October 30, 2008
Sunday, May 25, 2008
The end of MSI
Wow. I can't believe it's finally here! Finals are finally over...well, first year of med school to be exact...and now I'm sitting on my favorite couch at home in Vegas while ribs and shrimp skewers are being cooked on the grill:) I love summers in Vegas. It's super hot but it's always a great time. Gosh, what a sigh of relief. Well, we have not received our final grades yet but at least finals are over and now it's just a waiting game for our grades. I hope it works out...
Until then, I will be hanging out at home, catching up with Bones and Greys Anatomy, watching new movies, and maybe do some shopping for my summer trip to the beautiful islands of Samoa. I can't wait to go back home this summer! I'll be really busy with the survey I'm going to administer but I'll be catching up with old friends and people I haven't seend in about 7 years. Crazy how fast time flies!
But back to medical school, this year has been amazing and crazy and fulfilling and more than what I imagined med school to be. I learned an astronomical amount this year! A year ago, I would not have believed it was possible to learn this much, but the brain is an amazing organ and proved me wrong. I'm really scared on what second year will bring to my plate because I hear horror stories on how much MORE information there will be and how harder it's going to be, but I'm looking forward to another crazy year....well, not just yet. I want a nice long 13 weeks all to myself without medical school on the brain. I want to just chill and hang out with family and friends having bbq's and going to the beach and reading books other than text books. What a fabulous summer it will be...
Until then, I will be hanging out at home, catching up with Bones and Greys Anatomy, watching new movies, and maybe do some shopping for my summer trip to the beautiful islands of Samoa. I can't wait to go back home this summer! I'll be really busy with the survey I'm going to administer but I'll be catching up with old friends and people I haven't seend in about 7 years. Crazy how fast time flies!
But back to medical school, this year has been amazing and crazy and fulfilling and more than what I imagined med school to be. I learned an astronomical amount this year! A year ago, I would not have believed it was possible to learn this much, but the brain is an amazing organ and proved me wrong. I'm really scared on what second year will bring to my plate because I hear horror stories on how much MORE information there will be and how harder it's going to be, but I'm looking forward to another crazy year....well, not just yet. I want a nice long 13 weeks all to myself without medical school on the brain. I want to just chill and hang out with family and friends having bbq's and going to the beach and reading books other than text books. What a fabulous summer it will be...
Monday, April 28, 2008
Admissions committee
Yay, I just got the email today that I got the position on the upcoming year's admission committee at GW! I'm so excited:)
Saturday, April 19, 2008
Clorox bottle
Today is Saturday and the image of a large clorox bottle has been burned in my mind since Thursday. I went out to Virginia to shadow my CAP physician while he worked at a women's clinic for the afternoon. I knew before hand what type of clinic this was, but I really did not realize just how this visit would affect me.
In summary, I saw nine abortions in the span of an hour and a half. Virginia law allows only first trimester (12 weeks) abortions. I believe the District of Columbia allows abortion up into the second trimester. The latest term I observed was 11 weeks and 2 days.
I will not go into too much detail here just because I do not feel like reliving that 2 hour span just yet. My CAP physician is an amazing individual, I must say. After the day was over, we had a recap session and he asked me if I had any questions. Of course I had a million questions at this point, but I filtered my questions to just those I won't be able to find on my own. This narrowed it down to one important question, which centered around how he felt after doing his first abortion on a woman and how he deals with it emotionally patient after patient. I asked this because almost every woman was crying during and after the procedure was done. Their tears may have initially been spawned by the brutal clamping of the cervix but may have been exacerbated by the finality of their decision with the last pressure sucking sound of the vacuum. Do you know that sound a vacuum makes when it is struggling to suck up an object from the carpet or floor and then when it finally gets it up through the tube and the object makes its way into the vacuum container, it makes that strong pressure releasing sound? Now imagine me intently observing my CAP right behind him and underneath the hot lamp waiting to see what was to come out of this woman and into the clear vacuum tube. It was as expected. Slowly at first, clear fluid came out and then bright red blood and then a dark red mass. The pressure within the tubes then increased to get the large dark red mass into the vacuum container. The sound I was describing earlier happens right before you see the dark red mass. I'm assuming this dense material was the target of the vacuum tube. Finally, a quick dip into the clorox bottle to disinfect the tubes from HIV and other viruses and the switch is turned off from the vacuum.
I just could not help but imagine myself in the place of any of these women and how this two minute procedure could change the course of their life. I understand that abortions are necessary to give women options. Like my CAP physician says, "Everyone makes mistakes but I'm not that person to make them live with that mistake for the rest of their lives. I give them options." I'm still contemplating on his words as I think about the events of that Thursday afternoon.
The problem here is not understanding the necessity of abortions in women's health. It's more my problem in dealing with them emotionally. I imagined myself in the place of these women, but I also imagined myself not being able to go through with it. I also imagined myself as my CAP physician and turning the machine off before I inserted the tube into the cervix of the patient.
But I'm trying to reason this out. I want to go into public health. I feel that my education teaches me to be objective and to see it from my patient's point of view regardless of how I may feel about the situation. This is a conflict...a conflict between what my brain tells me what is right and what my heart and soul says is right.
I see a young girl who may have just finished high school and may not have the resources to rear a child on her own and I see how this procedure can help her situation because who knows? She may be on her way to college or she may be one of the sole earners in her household and may not afford for another mouth to feed. Whatever the reason, there is one. But... all my little heart sees at this point is the little 11 week fetus with a head and hands and legs and feet all on a petri dish submerged in clorox.
In summary, I saw nine abortions in the span of an hour and a half. Virginia law allows only first trimester (12 weeks) abortions. I believe the District of Columbia allows abortion up into the second trimester. The latest term I observed was 11 weeks and 2 days.
I will not go into too much detail here just because I do not feel like reliving that 2 hour span just yet. My CAP physician is an amazing individual, I must say. After the day was over, we had a recap session and he asked me if I had any questions. Of course I had a million questions at this point, but I filtered my questions to just those I won't be able to find on my own. This narrowed it down to one important question, which centered around how he felt after doing his first abortion on a woman and how he deals with it emotionally patient after patient. I asked this because almost every woman was crying during and after the procedure was done. Their tears may have initially been spawned by the brutal clamping of the cervix but may have been exacerbated by the finality of their decision with the last pressure sucking sound of the vacuum. Do you know that sound a vacuum makes when it is struggling to suck up an object from the carpet or floor and then when it finally gets it up through the tube and the object makes its way into the vacuum container, it makes that strong pressure releasing sound? Now imagine me intently observing my CAP right behind him and underneath the hot lamp waiting to see what was to come out of this woman and into the clear vacuum tube. It was as expected. Slowly at first, clear fluid came out and then bright red blood and then a dark red mass. The pressure within the tubes then increased to get the large dark red mass into the vacuum container. The sound I was describing earlier happens right before you see the dark red mass. I'm assuming this dense material was the target of the vacuum tube. Finally, a quick dip into the clorox bottle to disinfect the tubes from HIV and other viruses and the switch is turned off from the vacuum.
I just could not help but imagine myself in the place of any of these women and how this two minute procedure could change the course of their life. I understand that abortions are necessary to give women options. Like my CAP physician says, "Everyone makes mistakes but I'm not that person to make them live with that mistake for the rest of their lives. I give them options." I'm still contemplating on his words as I think about the events of that Thursday afternoon.
The problem here is not understanding the necessity of abortions in women's health. It's more my problem in dealing with them emotionally. I imagined myself in the place of these women, but I also imagined myself not being able to go through with it. I also imagined myself as my CAP physician and turning the machine off before I inserted the tube into the cervix of the patient.
But I'm trying to reason this out. I want to go into public health. I feel that my education teaches me to be objective and to see it from my patient's point of view regardless of how I may feel about the situation. This is a conflict...a conflict between what my brain tells me what is right and what my heart and soul says is right.
I see a young girl who may have just finished high school and may not have the resources to rear a child on her own and I see how this procedure can help her situation because who knows? She may be on her way to college or she may be one of the sole earners in her household and may not afford for another mouth to feed. Whatever the reason, there is one. But... all my little heart sees at this point is the little 11 week fetus with a head and hands and legs and feet all on a petri dish submerged in clorox.
Tuesday, April 8, 2008
Wednesday, February 6, 2008
A new friend
I know it's been a while since I last posted. Med school just took over my life last semester. I really was planning on diligent writing throughout school but I succumbed to the shedule overload and the writing inevitably was pushed to the curb. But, I'm back and with a vengeance. I attended a lecture today and speaker gave some casual advice to the eager ears of medical students of writing in a journal to keep note of important events through this period. I'm assuming we will all eventually become senile at one point in our lives and a journal would be nice to look back with painful but fond memories (talking about med school here).
I'm off-topic already and I just started writing this post about meeting a new friend. I met a classmate of mine today. Weird, I know. I'm in my second semester of school, which is six months into knowing my peers and yet I am still meeting people from my class! I met one yesterday too on a squash court! It amazes me that I haven't met everyone yet but what can you do? Actually, I take that back. I've met people in my class more than once...maybe more than three times. You know how it goes. You meet people and you forget their names so when you pass in the hallway, you're sort of embarrassed to admit you forgot their names after only meeting them the night before at so and so's party. And before you know it, three months have passed and you're meeting the same person AGAIN at some other person's party. This time you may have had a few drinks in you so the name slips for the second time! So you end up meeting them, this time sober, when you're in conversation with mutual friends and get introduced AGAIN. Hopefully, this doesn't happen too often or you'll be one of those people with no friends because you can't remember any of their names. You'll be a "smiley"...aka..the person who you always see in the halls smiling at you and you casually say hi because you know they're one of your peers but the conversation doesn't go beyond that.
I'm off-topic already and I just started writing this post about meeting a new friend. I met a classmate of mine today. Weird, I know. I'm in my second semester of school, which is six months into knowing my peers and yet I am still meeting people from my class! I met one yesterday too on a squash court! It amazes me that I haven't met everyone yet but what can you do? Actually, I take that back. I've met people in my class more than once...maybe more than three times. You know how it goes. You meet people and you forget their names so when you pass in the hallway, you're sort of embarrassed to admit you forgot their names after only meeting them the night before at so and so's party. And before you know it, three months have passed and you're meeting the same person AGAIN at some other person's party. This time you may have had a few drinks in you so the name slips for the second time! So you end up meeting them, this time sober, when you're in conversation with mutual friends and get introduced AGAIN. Hopefully, this doesn't happen too often or you'll be one of those people with no friends because you can't remember any of their names. You'll be a "smiley"...aka..the person who you always see in the halls smiling at you and you casually say hi because you know they're one of your peers but the conversation doesn't go beyond that.
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