Monday, February 24, 2014

Teddy Bear Hospital 2014

Once again Teddy Bear Hospital was an awesome success!!! 

Like last year I had one heck of a time trying to get out of class even with my deans office excuse  which we applied for almost three weeks prior to this. Basically, I was missing three hours of a rotation that doesn't even exist in the US and they wanted me to pay 600 zl to make up the class. But the real kicker is that they didn't tell me or anyone else this until the day before we were supposed to go. Needless to say those of us who were going were not having it. In the end we sorted it out with the head of the department so it wouldn't be a problem, but not without some serious anxiety first.

The whole group of us (about 8) all met at a local grocery store and cabbed it to the other side of town. The international school we affiliate with for this is not exactly close so it takes a good amount of time just to get there. Once we were there we got everything all set up and ready to go for the kids. Basically (if you don't remember from last years post about this) there are three stations and kids bring their bear to each station to try them out.

The first station is just basic sort of doctor stuff. The kids tell us what's wrong with their bears and we fill out a little piece of paper with the bears vitals and then we have the kids listen to the bears heart, take its blood pressure, check reflexes, give shots, and stuff like that. The funniest thing in the world is to play pretend with a five year old. "Why don't you listen to the heart? Can you hear it?" "Oh YES I CAN HEAR IT." (I must need my hearing checked).

The next station is "imaging." My friend and I made an x-ray out of a box and collected some old x-rays to show the kids (so that we wouldn't have to tell them that the ribs were an arm again).The kids would put their bear inside, we'd shake the box around, and then we'd pull out an x-ray showing the body part the bear was complaining about. Getting x-rays when most places use computers is a little tricky so we had a few print out versions.

The third and final station was the operating room. We had a big table covered in a sheet for this and some fake scalpels and bandaids. We also brought gloves and masks along for the kids so they could get more into the role. I remembered to bring my sewing kit this year because last year kids brought bears that were legitimately in need of some stitching. I got to sew up one dalmatian- though I don't think the kid really cared.

The kids we had this time around were younger than the ones from last time around ages four to six. And for many of them it was their first year of speaking English so trying to understand them or even get them to talk sometimes proved a bit difficult.

Near the end of our time there some of the kids were really riled up. So instead of releasing them to the teachers as wild hooligans we had everyone get in a big circle and we taught them how to do the "Hokey Pokey" because that's what cool doctors do.

Overall, we really had a blast and I think the kids did as well. If anything though it's taught me pediatrics probably isn't really my thing. I just can't relate with kids well and quite frankly I think they hate me.

Friday, February 21, 2014

The Woman in the Black Reeboks

The old woman was hysterical. She had come to the doctor for a simple stomach ache and the diagnosis ended with atrial fibrillation. She dabbed her face with a tissue as the nurse tried to calm her down. She was in her eighties, but this was her first major medical problem. "My son, I have to call my son. Where's my cell phone?" she cried over and over.

My classmates and I stood in the corner helplessly, not able to say anything to comfort her. Barely even able to ask her how she was doing. For the moment, I wanted nothing more than to be able to speak Polish.

The nurse let her lay on the ECG bed and the doctor instructed anti-anxiety medications to be administered. Almost twenty minutes later the woman was still shaking. Crocodile tears covered her wrinkly face and the doctor ordered the ailing woman back to the waiting room to wait 30 minutes before she would have another ECG. "We need the room, we have other patients," she said.

The nurse not at all pleased by the doctors decision half carried the anxious woman back to the small waiting room which was nothing more than a converted hallway where seven other patients sat.
Some time later the nurse and I half carried the woman back to the ECG bed. She had calmed down, but only a little- tears still filled her blue eyes. I helped lift her feet up onto the bed and noticed her black Reebok sneakers. The same type of sneakers my own grandmother wears on a daily basis.

The ECG was performed again and confirmed the diagnosis. The woman's son arrived half way through the test, and the look of relief on her face was enormous. Like any good son he was very concerned about his mother, checking to see if she needed anything, asking what was wrong. The woman was never told the diagnosis, the son was taken to the hallway to explain the situation and she was referred to a cardiologist.

Before the woman left to go the doctor performed an abdominal exam- Hermanski's sign was positive, she had guarding in her abdomen. The main doctor came in and conferred with the one who had done the exam. They spoke in Polish, so I still don't know what they decided the cause of the pain was.

While the woman was buttoning up her shirt the main doctor turned and said to us. "So there are some problems, but I think she is faking it. She is doing this for attention."

And that is the attitude towards most patients in almost all of the departments I have visited. But, it's fair to say it was the worst in family medicine.

Sunday, February 16, 2014


I spent the last week in nephrology. It was really tough, but fun. I think it's safe to say that I pretty much still have no idea what's going on with those crazy retroperitoneal organs that filter everything, but it's still much better than I was before. I actually kind of enjoyed the challenge.

The teachers in that department were a bit more "interesting" than some of the other places we've been. One professor found the need to insult our Polish skills at every given opportunity and then proceeded to drop us off at patients and leave us there alone to take histories- knowing full well that even the best persons Polish wasn't enough to get us through the exam. It was actually pretty annoying. I mean, if you don't want to be bothered with students, why volunteer to teach us? We don't need much, just someone to translate. Yes we want to know Polish, we are in Poland after all but making the patient and us suffer when we're taught everything in English is kind of silly. 

This same doctor found the need to berate the patients for not knowing their exact lab values- I mean what patient knows those? I'm in med school and I don't even know the values of the last blood test I had. Most of the patients she took us to wanted nothing more than for us to go away, and I really can't blame them. She also had a habit of dropping us in a hallway with a handful of x-rays/CT's and saying, "I'll be back, and when I do you can tell me what's wrong." Usually the x-rays were pretty easy, but with the harder ones it was really annoying to be left for 30+ minutes with not even a remote clue about what was going on only to have her come back and play 50 questions with us. Finding new and improved ways to ditch students seems to be a repeating trend here. 

Picture from:
Besides her, most of the teachers in the department were really great. Yeah one guy in my group got in a shouting match with the one doctor, but I'm pretty sure the doctor was right and the student was just having a bad day. We spent a lot of time watching ultrasounds and biopsies. My friend even got to numb one patient up for a biopsy! Even though I didn't really get to do anything it was so much fun to watch her do it. It was even more fun to watch her try to put on five pairs of sterile gloves and trying not to contaminate them. We should really have a class called 'sterile gloves 101.' The irony of the whole situation was that the window was open, and even if she and the doctor were wearing masks, frocks, and the whole get up- no one else in the room was. 

All in all I really wish we could have spent another week in nephrology- but with the better doctors.   Not just because I really need to learn more before I can even begin to be proficient but because even if it was stressful at times, it was also a lot of fun. 

Monday, February 3, 2014

Internal Med

My group has been in the internal medicine wards the last few weeks. We spend around a week in each ward, just enough time to barely cover a subject before we're whisked off again and start something else. Most of the doctors are really great and know their stuff but one week is NOT enough time to cover half the stuff you need to know.

We don't get to see many patients either which is kind of annoying, nor do we get to do actual procedures. I've yet to do a full physical exam, start and IV, learn how to do stitches or anything of the sort- you know stuff medical students are supposed to be learning. On the up side, the theoretical side is being taught much better than it ever was in our general science classes, and these doctors/teachers can actually speak English very well!

So far we've gone through cardiology, oncology/hematology, GI, and we've just started endocrinology. For the most part it's been as boring as all get out, but sometimes the doctors spark an interest in us.

When we were in oncology my classmates and I noticed something odd about the hospital set up. The oncology ward overlooks the cemetery. When I asked about this the doctor simply said, "It's a beautiful graveyard." And I'm sure it is- so long as you're not fighting to stay out of it! I personally don't think I'd be able to deal with fighting for my life when my only view of the outside world is a graveyard! But, to each his own!

The hematology department also let us do blood smears on ourselves which meant pricking our fellow classmates- we're 2 weeks out and I still have the mark! The nurse in a bid to show us what not to do grabbed ahold of my friends finger and caused a fountain of blood to spray across the room directly at me. I guess it's a do as I say, not as I do sort of scenario.

In GI we got to see a few colonoscopy's and endoscopy's which for the most part are kind of uninteresting. But, at least we got to see an actual procedure! I didn't know this but apparently they don't knock you out for endoscopy's here- I'm not sure if they do in the states, but either way having a person awake is kind of brutal. There was this one woman who was not having it! The doctor in charge was so frustrated he was swearing and carrying on like a five year old until a bunch of nurses literally pinned the patient down and he rammed the tube down her throat. All of the other patients went a tad bit more smoothly than that!

This past weekend my friends and I finally had a "free weekend" to hang out and have dinner. Most of them are in another group and are in surgery right now. Apparently it's even more boring than internal med ("yippie!"). I'm really looking foreword to trauma surgery though, it's the closest thing they have here to an ER rotation and I think that's the sort of field I'm leaning towards, then again there's still so many rotations to go, you never know I might change my mind!!!