Sunday, March 2, 2014

More Adventures in Internal Med

Classes have been going pretty good lately. Over the past two weeks we've had a few different classes all part of internal med. Namely: rheumatology, family med, and diabetology (yes, apparently that is a real specialty-I'd never heard of it before either).

Of all of them the rheumatology and family medicine rotation were probably the best of the three. The doctors in rheumatology spoke amazing English and were very helpful. And family med was good just because we were actually allowed to do things for a change. I got to give my first shot, we took blood glucose levels for all the patients who needed it, did physical exams, and all that sort of fun stuff. It was nice to be trusted and taught actual skills.

Even though we got to do a lot, the patients for the most part seemed like a bunch of (forgive this adjective) wimps. There were a few people who were legitimately ill, but for the most part it was "I woke up with a stuffy nose this morning and need a note for work." Seriously!?!? I've come to class with bronchitis both in med school and in undergrad because I'm not allowed to miss classes, not even one even with an excuse. And they're telling me they can't go work a cash register with a stuffy nose?

Okay, I get it some people just can't handle being sick. But, it seemed like ALL of them were looking for a way to get out of work. We even had one woman who was faking serious abdominal pain to get out of work- we only caught it because I said to the teacher in English that hermanski's sign was positive and while she was talking to her she checked and despite the fact the woman almost jumped out of her skin when I did it, she didn't even notice when the doctor did it. And most ALL of the injections I gave were narcotics.

I guess this explains why the doctor we were with pretty much thought every patient was faking it- most of them were. But, when patients were legitimately ill they got no sympathy. I guess once you see this sort of stuff so many times, you just stop caring about the patients as a whole. I dunno...but what I do know is I don't ever want to be the sort of doctor that brushes people off. I've had experiences with that, and when you are really sick it's very disheartening.

They see patients with it like this. 
Another interesting thing was the aesthetic quality of the clinic. It was messy, I don't mean just dirty, it was that too; I never saw anyone wash their hands, or clean the equipment not once in the entire week. It was messy, there was junk everywhere. The desks were covered in books and pamphlets, the walls didn't look like they'd ever seen paint, it was very "ghetto" and small, very small. And they saw patients in these conditions, better yet patients came to see them with these conditions. Back home if an office looked like this place it would have been condemned and there's certainly no way patients would actually elect to visit it. I understand money in clinics like this aren't the same here, but that is no excuse for the mess.

One of the best parts was when the drug salesmen would come in and pitch their drugs. The doctor wouldn't even pretend to pay attention, so my group was pretty much the only audience. One of my friends made it a point to convince them to give us free pens and notebooks. SCORE!

The only good part about diabetology, or at least the most interesting part was that we had class in a church, well next to it. The hospital had an extravagant chapel we had to go through to get to our classroom. Before we were about to take our final for the rotation our teacher jokingly pointed out that their was a reason we had to go through the church to get to the classroom. When I was getting ready to take a picture of it the first time, I quickly realized there was a priest hanging out, so I quickly hid my phone and took the picture later. I'm not sure how keen they are of people taking pictures of hospital chapels here.

I think we only have another two or three weeks of internal med before we start surgery or psych - I'm not sure which. I've enjoyed internal med, but I'm really ready for it to be done. If I felt like I were getting anything useful out of it the majority of the time I'd be alright, but I feel like I'm just going through the motions lately.

On another note, last Thursday was Donut Day! A.K.A Fat Thursday. Needless to say I'm still coming down from my sugar high. 

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