I live in a pretty small one bedroom apartment with my partner, Micah, and two dogs. Let’s just say that things get a bit crowded at times. For example, the four of us generally all sleep in one (slightly larger than twin) bed. The dogs have their very own “luxury sherpa” bed, but for one reason or another, they seem to prefer sleeping (literally on top of our legs) in our bed. Actually, Micah slept for a bit last night on their luxury sherpa bed. I think they were a bit confused. Micah had drank one too many beers, I think.
We also only have one tiny air conditioner that really only cools about a five foot radius around it. Considering that it is generally in the 90′s here every day, and it rarely drops much below 80, even at night, I rarely spend much time in my apartment farther than five feet from our AC. Now, in addition to the AC problem, we also do not have a couch in our apartment. It’s a very long story, but it involves the two aforementioned dogs, a rebellious uprising, and an excess of fecal material.
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I’ve always tried to be a good communicator. I really enjoy conversing with other people, and I consider myself to be fairly cognizant of others’ reactions. I try to alter subtle details of the way I speak depending upon who I’m talking to, and what the circumstances are. I’m certainly not perfect at it, though. And the more deeply I delve into medicine, the more I realize how critical it is to be able to effectively communicate with patients. I can only hope that I’ll do a decent job when I actually start working on the wards.
I once observed a fellow student interview a patient who had a very long list of complaints. After the patient finished describing each complaint, the student said, “okay, and that’s it?” The student was obviously hoping that the patient had no more problems that they’d have to explore. It was quite apparent that the patient quickly caught on to the student’s annoyance, as she eventually gave less and less information about each complaint.
Another time, I heard a patient mention that they used “bush medicine” to help treat their headaches. This being a Caribbean country, many people treat various ailments using bush medicine. However, instead of asking more about the type of treatment that was used, the student condescendingly said, “okay, so you don’t take medication, and you still feel worse.” The expression on the student’s face was obviously one of disapproval. It’s nearly impossible to get a history from a patient if you quickly dismiss what they’re trying to explain to you.
We’ve probably all seen at least one med student get so wrapped up in taking a history or performing an exam that they walk into the examining room without introducing themselves or asking the patient’s name. This “lack” of communication with the patient certainly does communicate a lot!
There are so many intricacies involved in the doctor patient relationship that it’s impossible to master every detail. But as a future doctor, I want to attempt to do the very best job that I can with every patient. A simple smile or an understanding nod can ease a patient’s anxiety and allow them to open up to you. Communicating effectively with patients is not just about the questions you ask, but rather how you ask them. The tone of your voice and the reaction on your face can frequently communicate more to your patient than their lab results or their diagnosis.
Taking a good history and being a good doctor requires paying attention to even the most seemingly insignificant details. Many doctors might be very adept at scrutinizing their patients in every way, yet they forget to turn their astute powers of observation on themselves. I hope that in my future practice I can remember not to focus so much on my patient’s details that I forget my own.
I just randomly felt like using some old footage that I had when I first got my camera and I was cruising the streets of Georgetown. “What the hell was I doing there? I don’t belong there.” Enjoy.
Since I had my headphones stolen (along with the other stuff from my backpack), and the Best Buy in Dominica doesn’t actually sell any electronics, I was forced to replace my nice Sony Sport headphones with the only pair they had for sale at the bookstore on campus. Unfortunately, they use a 1972 headphone design and technology, and they are “multimedia” according to the box (they have a microphone built in). Well, not that I really give a hoot about it, but I sure do look very stylish wearing them around on my runs. Because Micah is awesome, he bought me a new pair from the States. But his luggage has still not arrived, so I’m still using my slick “multimedia” headphones for running and listening to music. Tonight, Scope offered to do some secretarial work for me, so I allowed him to wear the headphones to make all my official, super important, business related phonecalls. I think he’s a actually quite a natural. Now if I can just teach him how to watch my lectures and take notes…
A friend of mine just took the MCAT and he thinks that he might have bombed it. He’s worried that he’ll never make it past this huge hurdle, and on to the next one: the medical school application process.
It made me think back to my “younger years” when I first decided that I wanted to become a doctor (that was about ten years ago “¦ my goodness I’m old). The first hurdle was making it through all the required pre-med classes. I remember thinking before one of my organic chemistry exams that it was going to be the end of me. Oh, how I loathed organic chemistry. And it made me wonder if I was truly cut out to be doctor.
Well, I made it past organic chem, and all the other pre-med classes. The next hurdle was the MCAT. Well, that monster was enough to give me a premature myocardial infarction. I remember the dread and fear I felt as I walked in to take that exam. But guess what: I made it.
Then it was on to the medical school application process. Ah, the joy of filling out one billion forms, writing the “perfect” med school essay, and figuring out how to pay for all the application fees. I never thought I’d even get in to med school with all the work involved! But guess what: I made it.
Once I got accepted to med school, I was sure that I was going to fail my first exam. I mean, how would I ever remember all the miniscule details that they threw at me? Surely, I was never going to pass. But guess what: I made it.
Thus far in med school, I’ve actually managed to do pretty well in all my basic science classes. But when the day came to face my first real patient, I was sure that I was going to kill them. But guess what: my patient did not die by my hands.
Next up on the menu is the USMLE Step 1 — the bane of every young (U.S.) medical student’s existence. Luckily, I don’t have to actually take it for another eight months. But as it looms on my horizon like a juggernaut with a death wish for me, the only thing I have to hold onto is that I have made it this far. I mean, what’s another standardized test when I have taken literally hundreds of exams in my life? I guess we’ll have to wait and see.
But to all you high school, college, pre-med, med, law, dentistry or what have you students out there: there is hope. Whatever obstacle might be staring at you right now, baring its razor sharp teeth, know this: the next hurdle is always the scariest, but tomorrow you’ll laugh in its wake (and then on to the next one).
I never thought I was one of those “needs to be around someone all the time” type of persons, but the past few days I’ve been questioning myself. Micah left on Saturday to attend a Mac geek conference in San Francisco, and I’ve been all alone since then. I have to admit; I’ve been feeling kind of lonely. I feel great during the day, but at night I start to miss having someone around to talk to. It’s not even that I need a human touch, but more that I need a human voice. My puppies do make nice surrogates, but unfortunately they haven’t yet learned how to speak English.
I had another epiphany the other day during my daily run. I realized that I have a lot of epiphanies. No, but seriously, I do. For those of you who know me, you can vouch for me on this one. I am what you might call an epiphany addict. I also had another epiphany during my run, which is that I really like living here. I’m starting to realize that I’m not sure if I ever want to live in the States again. Sure, I’d like to visit, but I’m beginning to understand that I don’t miss the traffic. I don’t miss the fast-paced life. I don’t miss the smog and politics.
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