Wednesday, March 30, 2011

Dr. D.R.E.

Class continues to progress.  Board exams relentlessly approach.  In a few months, I'll be in the hospital on rotations.  This journey seems so far from where it was when I quit work some years back and began this endeavor.  As I'm in the midst of what is the craziest bit of studying that I've experienced, I've not written very much lately.  Do, however, feel free to check out Scholarly Photos, a photo blog that I've created to provide some creative outlet in lieu of writing.  (See the links to the right; you'll know the one.)  I look forward to posting more regularly in the near future.  In the meantime, please accept the following yarn as a down payment on future posts.  
-- The Scholar

Yesterday, I shadowed a doc at an Urgent Care clinic.  In the past, I have been stunned at the variety of things that I've seen, amazed at her prowess in diagnosing and treating, and thrilled at what I've seen.  Late in the day, we saw a patient who presented with prostatitis.  We took a history, did a physical exam, and asked him for urine.  The doctor got a gown for him and asked him to change into it because we'd need to do a rectal exam.  Pretty cool, I thought, as I walked out of the room.

A few minutes passed and, during a break, she asked me if I'd done a rectal exam.  She asked if I wanted to do this one.  I let her know that I'd never done one but I'd love the opportunity as it would be a great learning experience.  As we went back into the room, I was pretty amped from the adrenalin and anxiety.  Like a hawk, I watched everything she was doing.  She asked the patient if he'd allow the student to do the procedure as a learning experience and he consented.  Immediately, I threw on some gloves and was overcome by a sudden urge to roll my freaking sleeves up as far as I could get them.  Seriously, if I was wearing a muscle shirt, the sleeves still wouldn't have been up high enough.  No worries, I was going in!

The doc gave me another quick demonstration which I pantomimed in the air.  I can only imagine the look on the patient's face as he overheard me repeating everything; poor guy must've been mortified.  Next, the doc and I tried to put a dollop of lubricant on my finger.  Turns out, the tube of KY was nearly empty.  Honestly, it was like fighting to get the last bit of toothpaste out of tube that should've been thrown out a week ago or, more specifically, exactly like someone nervously trying to get adequate lube on their finger before doing their first rectal exam on a patient.  Once successfully prepared, I approached the "entry zone," began the exam, and did my best to act out her instructions, being careful to try to listen with my fingers for any abnormalities.

After, I ditched my gloves, maintained my professionalism while I left the room, and, grinning, washed my hands as furiously as Lady MacBeth.

In addition to that patient, I helped suture a hand laceration, removed an embedded foreign body from someone's eye, did a few physicals, practiced OMM on two patients (a respiratory case and a shoulder rehab), and saw a bunch of sick kids.

My day was awesome.

I.  Love. Medicine.