Friday, October 14, 2005

An Open Mind

I decided to put off going into residency for the time being. I keep telling myself I just want to try to experiencing what it feels like to actually get paid for doing my job - but then again I'm not really willing to give up my 'self' time just yet. I found a clinic nearby that was looking for physicians to handle simple consultations and provide feedback to attending physicians about how their admitted patients were doing. The clinic is owned and run by Dr. D a general surgeon (I'll talk about him in later posts).

Yesterday was the first time I interacted with people as a 'real' doctor instead of someone just pretending to be one. There are so many things I need to recall, learn, and re-learn. One thing I realized was that the impressions my mind made of the patients I dealt with had a strong influence on my 'clinical' eye.

Around 7pm in the evening, I was already exhausted and my legs were aching from all the walking (it's amazing how much walking a doctor can do in just a 2-storey clinic) and there were still patients waiting to be seen. Dr D was the one attending to them (I was observing) when a 50-60 year old lady started talking loudly on her mobile phone. She sounded anxious and my mind automatically labelled her as one of those patients whose anxiety and stresses in life was translated into symptoms such as headache, palpitations, numbness of extremities and the treatment of which would be just to relax.

That was it, my mind spoke and that was the end of my assessment of her - never mind that she was still waiting for her turn to be attended to, never mind that I didn't know her medical history, never mind that I was just looking at her and hadn't even talked to her yet. My mind made an impression of the lady and that included her diagnosis.

As a doctor I should have seen that she was actually pale and sweating. I should have waited until I talked to her to find out that she had eaten something that didn't agree with her and caused diarrhea and she was dehydrated. Fortunately Dr D didn't make the same mistake and after giving her 500cc of IV fluid she was smiling and thankful to us.

There are many things still for me to learn but the most important things are those that can't be taught in school.
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