Monday, May 09, 2005
Clinicals. ( the last visit)
I was pretty tired. Probably from my fight with the printer till 2am the night b4. Saw a lot of arthris in the morning. INterviewd a patient about his presenting problem. Dr. TV took my suggeston and let me handle a few interviews by myself. After I was done, he asked me for my diagnosis..
"er... allergy? with inflammation of frontal and maxillary sinuses?"
He nodded. " And your management?"
" Er.. antihistamines."
"Good gal"
Saw a HSV case. And went with him to the nursing home. We examined this lady who had a stroke, who had permanent muscle spasms. SHe had incredible clasp knife rigidity. I was practically bent double trying to unclasp her hands. A musty dank smell rose as I bent her fingers back. My heart really went out to her. THe poor lady was contorted into a fetal position. Actullay, we found out that her daughter had changed the doctor in charge because she wanted Dr. TV. to do a CT scan on the lady even tho' the Dr had told her it was a muscle problem, not a bone problem.
Just made me realise how much medicine was really more of dealing with ppl than dealing with knowledge.
" IT's 50 % art, 50% science," Dr. TV said. " If you can't master the science bit, you're a charlatan. Ifyou can't handle the art bit, you're better off in a lab."
Every human is so unique! NOt only in the presenting problems .. but it's relaly the dreaded Biopsychosocial model walking right through the door. From the lady with multiply med problems who broke down and cried because she couldn't cope anymore and her husband was in a nursing home. To the guy who had to look after his wife... to the teenager whoes sprained ankle I examined and who was telling me how he and his frens fooled the gals in a basketball game they played.
And then there was this schizophrenic. I"ve never met one face to face before. I 've written an essay on this condition, but it was quite an experience to talk to someone who was going thru it. He had insight to his condition now, and i noted he quite circumventing my questions. Dunno wheter it was coz of his emotinoal blunting or because he was embarrassed by his conditions.
" it's a curse,' the doctor sighed.. as he debriefed me on the drive back to my house. " that conditons is a curse."
It's sad ... you become a doctor coz you wanna help.. but sometimes.. the will just ain't enough. Coz pple walk in with so much more than med problems.. I feel overwhelmed sometimes. Interviewing is a tricky art. I had a lot of difficulty interviewing this pt who kept giving me roudn about answer.
" I felt like we couldn't connect. " i complained.
" You've got ot hav e a 6th sense, " the doctor said. " It's like having someone watching you. Even if the smelliest, most horrible person walks into thtru that door.. he or she is a gentleman and a lady.. and you treat them likewise. WIth that awareness.. you 'll be able to guide the interview better."
Hai... I wanna be like Dr. T.V.. he's so kind, understanding..such a patient teacher... Never condescending.. open to suggestions and with such a wonderful sense of humour.. :P i'm gonna miss him and clinicals so much.
I was pretty tired. Probably from my fight with the printer till 2am the night b4. Saw a lot of arthris in the morning. INterviewd a patient about his presenting problem. Dr. TV took my suggeston and let me handle a few interviews by myself. After I was done, he asked me for my diagnosis..
"er... allergy? with inflammation of frontal and maxillary sinuses?"
He nodded. " And your management?"
" Er.. antihistamines."
"Good gal"
Saw a HSV case. And went with him to the nursing home. We examined this lady who had a stroke, who had permanent muscle spasms. SHe had incredible clasp knife rigidity. I was practically bent double trying to unclasp her hands. A musty dank smell rose as I bent her fingers back. My heart really went out to her. THe poor lady was contorted into a fetal position. Actullay, we found out that her daughter had changed the doctor in charge because she wanted Dr. TV. to do a CT scan on the lady even tho' the Dr had told her it was a muscle problem, not a bone problem.
Just made me realise how much medicine was really more of dealing with ppl than dealing with knowledge.
" IT's 50 % art, 50% science," Dr. TV said. " If you can't master the science bit, you're a charlatan. Ifyou can't handle the art bit, you're better off in a lab."
Every human is so unique! NOt only in the presenting problems .. but it's relaly the dreaded Biopsychosocial model walking right through the door. From the lady with multiply med problems who broke down and cried because she couldn't cope anymore and her husband was in a nursing home. To the guy who had to look after his wife... to the teenager whoes sprained ankle I examined and who was telling me how he and his frens fooled the gals in a basketball game they played.
And then there was this schizophrenic. I"ve never met one face to face before. I 've written an essay on this condition, but it was quite an experience to talk to someone who was going thru it. He had insight to his condition now, and i noted he quite circumventing my questions. Dunno wheter it was coz of his emotinoal blunting or because he was embarrassed by his conditions.
" it's a curse,' the doctor sighed.. as he debriefed me on the drive back to my house. " that conditons is a curse."
It's sad ... you become a doctor coz you wanna help.. but sometimes.. the will just ain't enough. Coz pple walk in with so much more than med problems.. I feel overwhelmed sometimes. Interviewing is a tricky art. I had a lot of difficulty interviewing this pt who kept giving me roudn about answer.
" I felt like we couldn't connect. " i complained.
" You've got ot hav e a 6th sense, " the doctor said. " It's like having someone watching you. Even if the smelliest, most horrible person walks into thtru that door.. he or she is a gentleman and a lady.. and you treat them likewise. WIth that awareness.. you 'll be able to guide the interview better."
Hai... I wanna be like Dr. T.V.. he's so kind, understanding..such a patient teacher... Never condescending.. open to suggestions and with such a wonderful sense of humour.. :P i'm gonna miss him and clinicals so much.
Comments:
Post a Comment
