Monday, March 24, 2008

Yup. New Template.

Hey, it's getting toward the end of my classroom phase -- and that means it's that much plus a few days until my wedding. Seems like as good a time as any to tinker with the settings. And that old customized teal-and-orange stripe was looking old n' busted.

Um, yes, I am also studying for a test. Why do you ask?

Wednesday, March 19, 2008

I'm Going In...

Wish me luck. The last of the standardized patient training deals is coming up for me.

You'll recall that just a month or so ago, I learned the correct way to perform a breast exam. The right kind and amount of pressure; the right technique to make sure you don't leave anything out, so I'd feel a suspicious lump, but I wouldn't take forever either.

Then I learned how to work the male exam; the outer and inner survey of the twig n' berries, the dreaded hernia check. I'd had these in yearly checks, but this was from the examiner's side. And then I got schooled in the prostate, a skill that I know will eventually become not just un-special, but actually boring.

Consider that, right? A day is coming, and it's not too far, when I'll not only be the guy responsible for giving the one-fingered salute to people, I'll grow to hate it not because eww, it's my finger in somebody's pooper, but because gawd those are so boring.

Well, another one of those things we do a lot of in the ol' clinic or Emergency Department is the friendly neighborhood pelvic exam. Guess what I'm doing this week?

I definitely feel like I'm turning into a clinician, so that's good. But, man... I am getting SO TIRED of looking at either male or female genitals. And how messed up is that?

Saturday, March 15, 2008

It may look like a walnut...

There is a notorious phenomenon that occurs in people who are in medical training; as you learn more and more about the various things that can go haywire with the human body, you gradually come to believe that an implausible number of them are happening to you. I believe that some of the reason my school's student-health clinic is staffed with semi-retired old docs is that they've seen and done everything, and most of the reason is that none of us are ever actually sick.

I, being older and presumably wiser than many of my classmates, have avoided too much trouble with this. I had a hacking, body-shaking cough for about 8 or 9 weeks, but I knew that was just a virus, combined with the dry air, combined with my train commute and incarceration in the same windowless classroom every day. Even when Teslagrl told me to go get a damn chest x-ray, I knew it wouldn't show anything. And anyway, we covered chests & lungs in the Physical Exam class, and nobody could hear anything wrong.

But then, a couple weeks ago, we got around to the male genito-urinary exam. Yeah... so I'm 37. You see where this is headed?

Before learning the correct way to inspect, cradle, squoosh, and prod another man's junk, and then go around back and knock on the back door, we learned the right way to talk about the exam. What it is, what it isn't, and why it's important. At my school we use 'professional patients,' people who are trained in much the same way we are, with all the attendant anatomy, physiology, and pathology... but from the other side. They learn how the exam is supposed to feel, when done correctly, so they can tell us stuff like "okay, you can press a lot harder than that," or "yep, you're right over it now; you should be able to feel it."

Yes, it's weird, and even though we'd already done the breast exams, the five dozen or so in my program were all quietly freaking out on "Nuts & Butts" day. We went into rooms in groups of four, which somehow made it worse. But once the guy did his intro speech, dropped the Caesar Ocatvius sheet he had added to his patient gown, and the first volunteer got to business, it was all very technical and interesting, and somehow we were all professional and more or less relaxed.

So, speaking now as a future professional, it's not a big deal. And the thing is, it's really super-imporant. A decent exam takes three minutes out of your life, it doesn't hurt, and it involves no needles and no radiation, unlike so many other tests. And the risks of being a big wuss about it and doing nothing are fairly dire. Ask Lance Armstrong about that.

Which brings me back to my own experience. Having honed my little speech, I had to consider my own very mild symptoms, from the past year or so. Nothing major, really, but some research pointed me toward an issue with the tissue, in the palace of the pants. Gradually I had to admit that if I were hearing from a friend what I was thinking, I'd tell that friend to go in and get checked. So I had to go see the stately, joke-cracking, HMO-hating doc over at the clinic.

This is a guy who graduated the very same medical school, more than 40 years ago. He's kind of a role model for me. He works pretty much because he loves medicine, and he'd be bored out of his mind puttering around at home with, I don't know, bonsai trees or model trains or some shit. He'd much rather be gloving up and getting to know me better than either of us anticipated.

He needed to leave for a minute to go find the tube of lube. I told him to TAKE ALL THE TIME YOU NEED, man. Search high and low.

And it turned out fine. My prostate is, apparently, awesome. I have no blood anywhere it's not supposed to be. Best of all, that info is documented, bitches! I'm not saying the exam doesn't suck just a little, but it's no worse a sensation than, say, the feeling of having crud stuck under your contact lens. It's less painful than irritating. You go ow ow ow ow shit ow, and you take out the lens to wash it. Then you're fine. And I'd rather have a rectal than some of that bullshit that dentists do to your gums with metal hooks.

The preliminary diagnosis? It would be nice if I didn't have to sit motionless for ten hours a day. So basically, my man-bits are suffering from IRONY. But yes, I absolutely did the right thing by going in.

The moral of the story for all my friends who are, or who love, guys: a dude should check his sack, once a month. And don't fear the finger.

Saturday, March 01, 2008

Dang, I forgot Albania

This was harder than I thought. Admittedly, it's also something of a spelling (and typing) test.


But hey, naming a new country once every five seconds for five minutes solid isn't so bad, right? Give it a shot; how many did you come up with?

Such Conflict!

Here's pretty much the central dilemma for any health-sciences student who has a blog, and tries to tell interesting stories: how much can you say, without messing up the educational experience for yourself, your classmates, or your patients?

Anyway, wait for a respectable period of time to pass -- I'll think of ways to change around the identifying details, and then I'll be able to talk about my first breast exam.

(Note: not my breasts. I'm not a skinny guy, like I was in high school, but aside from that thirty-something softness in the belly, I'm not hefty either.)