Monday, February 27, 2012

Being an example

Today was consumed by neurology orientation.  I don't know how I used to sit through entire days of lectures for two whole years of med school (and all the years before that)!  But the endless day of lectures isn't the point. 

The point: don't volunteer to be an example.  The clerkship director asked for a volunteer to demonstrate a proper cranial nerve exam on.  No one was volunteering and so after what felt like hours, I finally raised my hand and took the seat front and center of all my peers.  In the process of doing a proper neuro exam on me she discovered that I likely have carpal tunnel syndrome to some extent or another.  Lovely.

I'm not surprised at all by her observation.  I've had off and on wrist pain for a long time thought it is usually when I've been over using them: knitting constantly, signing (ASL), and typing at odd angles such as when I worked as medical assistant.  Plus, she only found a defect in my left wrist (my non-dominant hand) and it was a really cursory haphazard exam. 

BUT carpal tunnel syndrome is one of my biggest fears as I prepare for a future in OB.  [Along with my fears of loosing my eye sight or limbs to years of chronic type I diabetes.]  So many older doctors I know have given up delivering babies or preforming intricate surgeries due to wrist problems.  Having a fear pointed out in front of a room full of classmates doesn't do much for one's self esteem.

Wednesday, February 22, 2012

Appearance (aka my mom was right)

Blow drying my hair and wearing makeup really does make a difference with the way patients interact with me.  I'm treated more like the 27 year old I am,and less like a high school student pretending to be an adult. This is especially true when I'm wearing scrubs.  However, while I can rally to add an extra 10 minutes to my morning ritual for makeup and hair, I'm pretty sure I wont be swapping my danskos out for high-heels anytime soon.

Sunday, February 12, 2012

The ancient art of obstetrics

I've decided that I'm going to need to supplement my obstetrical education to include the usage of forceps, assisting mom to deliver in positions other than supine, vaginal breech deliveries, vaginal delivery of twins, and external version.  I'm sure there are a few other ancient tricks that would be good to learn too but I don't yet know what they are!

I can almost guarantee that I will not adequately learn these techniques in the US and that there very well may come a point in my career where these skills will mean the difference between life and death of a mom or baby.  I imagine that I'm going to have to spend some time abroad to learn these tricks!

Sunday, February 5, 2012

Lost in Translation

I recently had my first experience using a medical translator in order to communicate with a patient.  Actually, I had to use 2 different translators for 2 different patients in the same day.  One experience was relatively neutral, the other extremely frustrating as the entire conversation seemed to be lost in translation.

At the hospital I'm currently rotating through, the translators come via a speaker phone on a language line.  My understanding is that this has become the most financially affordable way to translate and also allows for access to an increased number of languages.   Speaker phone means distraction from background noise in a busy hospital, a lot of need for reputation, decreased clarity, and a lack of visual ques. 

The frustrating experience involved an attempt to gain informed consent for a necessary surgery.  Informed consent is already a complicated song and dance as it is a multi-step process with nuanced details that make little sense to someone without strong medical literacy.  [The predicament of informed consent can, and probably will, be a whole different blog post all together.]  Add in a speaker phone, translator without proper terms for female anatomy, and language without words for "laproscopic", and you have an ugly mess.  We spent an hour and a half with that patient and I'm pretty sure she walked away more confused than when we started.   She answered in the affirmative to statements of understanding and denied having any questions but her face said different.  I'm sure that I'm not the first to be frustrated with these experiences and I have no idea how to make them better, but I really hope that this conundrum progresses throughout my career.  Part of my interest in healthcare is to educate my patients and I certainly hope that I can learn to do better than what I experienced.

Saturday, February 4, 2012

Seeking advice

What resources should I use for step 2 studying?  What should my study schedule look like? 

I feel like there is much less advice circulating for step 2 studying then there was for step 1... and G!d only knows that I need to do better on step 2 than I originally did on step 1!