Clinical Medicine

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“Sir,” I said, “You’re not going to like what I have to do next,” I told my 79-year-old patient with belly pain.

“What’s that?” he said.

“Anytime there’s abdominal pain,” I explained, “We’re supposed to do a rectal exam.”

“You’re not going to like it either,” he replied.

“That’s true,” I told him. “But the good news for you is that I have slender fingers.” And so begins the third year of medical school.

The first two years of medical school are mostly book learning, studying all of the time, and learning the theory of medicine. Third year is where it gets real. I have to do a variety of clerkships (Surgery, internal medicine, pediatrics, psychiatry, neurology, family medicine, and obstetrics and gynecology.) This is where I try to apply what I’ve learned over the past two years. Most of the time, I have no idea what is going on, but sometimes, I am actually useful. I mean, the surgeons need someone to cut the knot right? And retract skin back during surgery, I can do that!

For instance, I did trauma last weekend at a level 1 trauma center. There, I dressed up in a mask and gown and responded to a variety of traumas. Mostly car accidents and motorcycle accidents (Lesson 1: Wear your seatbelt/helmet/leather). There was a little girl who was hit by a car and a man who got into an accident with farm equipment that broke both arms. It’s crazy busy and stressful, but I helped by cutting off clothes and turning the patient around. Sometimes, you can just help by offering an extra hand or providing some comfort to the family.

I’ve been in the clinic for a whopping week now, and I’m learning a ton. I’ve looked at more butts this past week than anytime in the rest of my life. Also, I helped change the diaper of a WWII veteran, so yay? I’ve had some fantastic patients and some grouchy ones. The trauma ones were unsurprisingly irritable, but I think I would be too if I was in a major car accident, helicoptered God-knows-where, and then surrounded by strange people in sterile gowns and masks who were cutting off my clothes. Once the narcotics kick in, they tended to calm down.

I haven’t figured out what I want to do, but I’m leaning against surgery. The hours are neverending and being in the OR is very stressful. You can’t touch anything and the nurses watch you in case you break the sterile field, which is a huge no-no. One of my teammates gave himself a needle stick today and had to go to the OR. Nurses are often annoyed at med students, and that only confirmed their annoyance.

Tomorrow there’s a hernia repair. Gotta read up and study for that. Exciting times.

 

M3 Orientation

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The Husband is learning lots of new things this week in preparation for entering the clinic, like inserting Foley catheters and doing blood draws.

Blood draws were practiced on fellow students, and I’m not sure what exactly happened, but I know The Husband’s partner was “stoic” and I was asked to make an apologetic batch of cookies.

Halfway!

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Yesterday The Husband listened to his final classroom lecture of Med School.  Tomorrow he will take his last M2 exam (Neuro).  Whoo!

We will enjoy a lovely free weekend with friends.

Then on Monday, Crunch Month begins. Boo!

The first day will be Dr. Costanzo doing a Physiology Review.  (Yes, that Dr. Costanzo.  She literally wrote the books.)*  Then the next 29 straight days look like this:

CrunchMonth

Every day, 7 days a week, 8 in the morning to 10:30 at night, with a break for dinner.  Step 1 is June 11.  M3 Orientation starts June 30, so there will be a glorious 18 days of freedom!

 

* True story from one of the other HPSP students who went to officer training last summer:

Med Student/Officer not from MCV:  I love Costanzo’s books!  I don’t bother going to the lecture, I just read her book.

Med Student/Officer from MCV:  I don’t.  I just go to her lectures.

 

Even Harvard digs on her (Shout out at 0:58).

She’s also really approachable.  One of The Husband’s classmates found an error/vagueness in her book regarding the morning-after pill and brought it to her attention.  She is correcting it in the next edition.

Psychiatry

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Well, The Husband finished his Psychiatry unit right before break, so we now have a totally unofficial diagnosis for The Toddler:  Cyclothymic with a conversion disorder.

This diagnosis could apply to all toddlers, in fact.

We’re also pretty convinced our former tenants had some sort of personality disorder, perhaps paranoid.

For the sake of marital harmony, The Husband declined to diagnose me.  I always knew he was a smart one.

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