ALF and PE guinea pigs

Yesterday, on my first visit to the assisted living facility (ALF), I managed to incur the wrath of the doctor in charge before we were even assigned patients! After we met Dr. L, one of the on-site physicians, he led us down the halls of the facility, peeking in to patients’ rooms and asking if they’d mind having a bunch of medical students mess with them. When he emerged from one, he shouted, “Anyone speak Spanish?” Even though I was, at one point, quite good at Spanish and had visualized myself conducting an interview so fluid and fluent Telemundo could’ve televised it as I lay in bed the night before, my anxiety got the better of me and I blurted, “…not well enough.”

“Don’t be a smart@ss!” Dr. L yelled, and tears sprang to my eyes. He came out of the room and fixed me with a frightening glare, his voice dripping with disdain as he told our faculty doctor, “I asked if they could speak Spanish and this one,” he pointed, “says, ‘Oh, not well enough!'” He inflected it with a girly additudinal lilt*, shaking his head. “Sounds like she should be a lawyer.”

I was mortified! “No, I didn’t mean…I’m sorry, I wasn’t talking about everyone, I didn’t mean them, I meant me, I don’t speak Spanish well enough to feel comfortable and do a good job, and I…” As I stammered out apologies, he chuckled.

“Well, here’s a patient for you.” Dr. L directed me and my partner to another bed in the room. “These two young ladies are medical students and they’d like to talk to you. Is that all right?” The patient agreed and Dr. L left us to introduce ourselves. When I made my introduction, the patient gave me a knowing smirk and said, “Oh, so you’re the lawyer.”

Blushing**, I shook my head. “Not really.”

Although I’d been nervous about having to conduct a full H&P on what I feared was going to be a demented, lightning-speed Spanish-speaking or uncooperative patient, I actually ended up with possibly the easiest patient in the place. He was fairly young with no cognitive deficits, no dementia and a pretty straightforward chief complaint. I didn’t have to worry about my rusty mediocre medical Spanish since our patient was a native English-speaker and had no trouble understanding us. I didn’t even have to do it alone!  So for my first rotation experience, it was a pretty gentle one. The only downside is that Dr. D (who’d accompanied us to the facility and to whom Dr. L told on me for being a smart@ss [I didn’t mean it like that, I swear!]) warned us that he’d met our patient and because his case was so straightforward, our write-up was going to have to be double plus good***. Luckily, we have the day off today so I’ll be working on crafting a masterpiece.

One of the things I realized since we began this semester is how mediocre my physical exam skills are. I thought I was okay when we were on the island but standards are a little bit different here. Towards the end of the semester, we will be evaluated on our physical exam skills – we’ll have 45 minutes to complete a 200 point physical exam (like a 200 point inspection…of the body!) and this time, they’re not testing to see if one can perform a certain task but instead, how well one can perform all the tasks and they are looking for perfection. I have a PE partner (who is also my carpool buddy) but as I began to realize that my skills needed quite a bit of honing, I figured that I might need someone in addition to her for some extra practice. Ideally, this person would be willing to allow me to perform procedures as many times as it took for me to get them perfectly with nary a complaint. In other words, not a PE partner but rather, a PE guinea pig. I think I may have been a little too provocative when I mentioned this on the social networking site to which I subscribe. Actually, scratch that – I was deliberately provocative – what better way to get people to volunteer to be poked and prodded and have their arms squeezed and valves palpated and auscultated and such? I just didn’t expect the enthusiastic response…

*I totally did not say it like that.

**Although embarrassed, I felt a simultaneous spark of pride – my daddy happens to be a lawyer and is also one of the people I look up to most, so it’s not so bad to be likened to him.

***i.e., the most awesome paper ever written

Explore posts in the same categories: 5th semester, med school

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