Thursday, April 18, 2013

Internal Med: Day 1

In case you couldn't tell, I'm the one on the end! 


It's so awesome to be out of the normal drone and groan of lectures and classes. Yeah we still have lectures, but we do get to see patients! And that is more than enough to keep me happy. 

Our class is broken up into groups of about six people in each group and distributed to various departments to be taught the basics. The Doctors from my department are really great, they speak excellent English (which is a nice change) and they are teaching us so many new things (also a change). 

Unfortunately, because of a bacterial outbreak in the ward, there are not any patients, because they had to close down for cleaning. But, we've been kidnapping patients from other departments and harassing them accordingly. 

It's really strange here. Back home I assume that in most cases we would go to the patients room to examine them. Here the patient comes to us. All six of us plus our two professors are seated around a large table and the patient comes in and either sits at a small bed on the side of the room or on a chair near the front by the Doctors. Once they come in, the selected classmate goes up to them, introduces themselves and begins trying to take a history- while the rest of us sit there like idiots. The major issue here is none of us really speak enough Polish to have a conversation about anything apart from ordering food at McDonald's, so one of the Doctors has to translate and inevitably things get left out. 

I imagine this is equally as awkward for the patient. There are eight of us and one of them. We also can't understand anything they're saying, and they can't understand anything we're saying. So slowly we get their symptoms with the doctor stopping every now and then to interject his two cents about a variety of issues: what sort of questions we should ask, how we should phrase certain things, disease specifics, etc... Meanwhile the patient is sitting there, probably bored out of their mind while we're talking about them and all the horrible diseases they might have with them totally oblivious. 

It also has to be strange for the patients to talk about some things with such a large audience. We ask them everything from bowel movements to sexual activity- that's something I'm sure most people want to discuss with a group of 20 somethings.

It gets really interesting when no one has a question for the patient. One of the doctors has to lead us on and sometimes we end up sounding like real idiots. For example: 

Doctor: And what other symptoms can you question him about related to his diabetes?
Doctor: What is he wearing?
Student: Uh...A red shirt.
Doctor: *shakes head* GLASSES

Yep- we're going to be doctors one day! 

And then of course there's the whole physical exam bit, which none of us have any real experience in. So needing to practice we all have to try everything. So there are six of us practicing auscultations and abdominal palpations on one poor unsuspecting patient, who has already been in the room with us for about two hours while we attempted to take a sufficient history. We had one woman there so long she was on her phone texting people while we all palpated her. 

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