Wednesday, October 5, 2011

Diagnosis: alien in chest?

You know how sometimes you think you will be really good at something, and then you aren't?

That feels like a lot of my experiences at medical school. And I'm only 6 weeks in! I study a bunch for my exams, feel like I rocked them, but then only do mediocre. Good thing it is pass fail.

We had a patient simulation several weeks ago. This consisted of 8 actors who were pretending to have symptoms. We had 15 minutes with each patient to interview them.

Now, before this exercise, I would have told you that I would nail this! I was really excited, and I'm fairly decent with people. So why would there be any problems?

Here's how my first interview went:

"My name is K8, how are you today?"

"Eh, I'm doing alright." *silence*

"What brings you into the clinic today?"

"Well, my vision's been a little blurry. Like when I'm trying to read." *silence*

"Tell me more about that."

"Well, you know, just blurry. Like fuzzy lines."

Now, thoughts are racing through my mind: what the heck do I ask about eyes? I don't know ANYTHING about eyes. I don't even have glasses. The last time I went to the eye doctor was to be checked for moles. Nothing vision related.

Oh crap, oh crap, oh crap.

"Er, anything else unusual?"

"No."

Oh crap, oh crap, oh crap.

So I began asking about lifestyle habits. Eventually, she said:

"I've had to go to the bathroom a lot."

"Oh yeah? #1 or #2? I mean...er, peeing or...ummm"

*interrupted* "Urination, yes."

I wanted to facepalm. Yes, I actually used the word pee in front of a very "upper class" acting patient.

Finally, something to latch onto!

"How often do you urinate?"

"Like 3 times a day."

"Do you wake up at night to urinate?"

"No, it doesn't wake me up."

Ooookkay. So am I just super weird, or is this the norm? Because I use the bathroom about 7 times per day, and get up NO LESS than twice a night to go pee. And I'm not even pregnant.

Alright, so now I have two symptoms.

1. Frequent peeing
2. Blurry vision

Honestly, I had no idea what this indicated. None. Not even the slightest hint. For all I know, it could have meant metastatic cancer, or an alien growing in her chest.

So go ahead, shout out the answer to me.....OOOOHHH DIABETES.



Well the interview just went downhill from there.

But the good news is that my second interview went very well. An elderly woman came in for a follow-up from her hip replacement surgery. She started to cry when I asked her about her husband, but now I was in familiar territory. It's much easier for me to ask and council about psychological state of mind than physical things at this point.

Since I don't even know that frequent urination and blurry vision = diabetes.

So much to learn. And so humbling.




2 comments:

  1. If it's any consolation, the first time I did a practical exam I totally missed the classic symptoms of CHF (exertional shortness of breath, orthopnea, nocturnal dyspnea) and therefore missed the diagnosis. I thought the patient had lung damage from smoking and counselled the patient on smoking cessation. For most people, the feeling of not doing as well as you want to and being in over your head never quite goes away.

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  2. Haha, awesome. I'm sure this won't be the last diagnosis I miss. =/ Looking forward to that.

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