HCW: Communication

Today we had Grand Rounds and watched as a gyn-onc physician showed us videos on how to use robots to remove tumors (surgery of the future). It was pretty cool, but also early in the morning so I was a bit tired. He looked familiar and I knew I'd heard his name before, but it wasn't until I talked to Dr. G that I remembered where: at the cancer center where I did a community observation last year. Hard to forget a name like his, after all.

I was alone at the HCW with the residents today, and maybe it was just as well b/c there was nothing to do. At one point I got to interview a patient with secondary amenorrhea that presented after she had unspecified abdominal surgery (don't ask). When I first talked to her, she was charming and talkative, complimenting me on what a good listener I was, but that changed after I told her I'd "bring the doctor in" and left the room. I'd told her earlier that I was a medical student, but when I came back later to tell her the doctors would be there later and offered some explanations on what could be causing her amenorrhea, she turned cold on me. She said she was not interested in talking to me anymore or hearing the opinions of a student since she blamed a student for doing her abdominal surgery that caused her all these health problems. Ouch. I was surprised, but respected her wishes and got the attending, Dr. T, to take a look at her. When he arrived with me, she told him, "You should have done this from the start, have her come in with you." And he calmly explained that as a student, I had to learn by talking to her first (and he wondered why I didn't dare to give her a pelvic exam?) Once he assured her that her uterus was intact and all right, she was a lot nicer and felt better. But...it didn't explain all her abdominal pain, so she needs a sonogram and some labs drawn.

It seemed like everyone was too busy to entertain the med student today. Drs B, K, and G were off doing their own thing and Drs C and D were busy talking to pre-op and post-op patients, so I tried to make myself useful by interviewing some of Dr. C's patients (even after she told me to follow the FPs). Pre-op patients were pretty fun and interesting to talk to. There was one patient that was coming in to hear that she had adenocarcinoma, which was a doctor only talk so I wasn't allowed in the room. Another 81-year-old patient had a cystocele (bladder prolapse) so the doctors had to insert a speculum in her (major "ouch" factor there...) for an exam. She also had a textbook case of lichen sclerosis, which is normally treated with topical steroids but contraindicated for her since she was also diabetic. Dr. K recommended giving her steroids, but Dr. D chose not to b/c of the hyperglycemia it would cause, so Dr. K said okay.

The few patients I did talk to (after the amenorrhea patient) were very talkative and had lots of fun stories to tell about their families, and I liked talking to them. One lady worked at LHS, my high school, and from that conversation I learned that Dr. K graduated from MHS. Pretty cool how we're both from the same town. At any rate I hope I made a good impression on Dr. K, which I definitely did not do in front of Dr. P (who was hanging out in the clinic during lunch). The doors to the break room (where the microwaves were) were locked, so I asked Dr. P how to get there. He laughed and said that if I just walked through the office, there was a connecting door that led to the break room area. *smacks forehead* I knew that...now Dr. P has three reasons to think I'm a total idiot. Ah well, like he said, he won't be evaluating me at the end of the rotation.