Wowee...what a dense and wonderful rich few weeks.
With the transition to my Thanksgiving break and my flight back to the northwest, my focused shifted towards family time, cooking/baking, and catching up on sleep. I will provide a short recap of the highlights from the two weeks prior.
Sunday, November 13 - I spent the morning at Arbor Free Clinic again, this time in the regular clinic (rather than the Musculoskeletal or Women's Health specialty clinics). I only was able to see one patient due to the complex nature of the case (older Chinese woman with her daughter as an interpreter and a significant history of chest pain with other chronic conditions as well as a history of little medical care). The clinic was short staffed in terms of physicians that morning, so everything was backed up as all of the pre-clinical students 'lined up' to present their patients and proceed with the rest of the visit. I found my encounter/interview with the patient to be really wonderful and I feel like I am becoming more and more comfortable interviewing patients that cannot speak English. I am really grateful to be having some of these challenging patient scenarios very early in my medical education.
Alex returned from his trip to Oregon on Monday, the 14th, and then my week just sped up dramatically.
Tuesday, November 15th - I attended a Career Exploration Workshop led by the academic deans that gave us a glimpse into how people tend to find their niche in medicine and what considerations often play a part (and should) in deciding what specialty you want to go into. There was a focus on how much patient contact we want in our careers and how we want our specialty choice to support/nurture our other life goals. I found it to be a very useful session, although the prelude to residency applications and residency committee decisions seemed a little premature (although there were older students in attendance) and I found myself with a bit of the 'deer in the headlights' syndrome by the end of the evening.
Wednesday, November 16th - I had the usual pediatric rounds in the morning (wonderful as always), followed by a one-on-one meeting with my clinical advisor, then lunch with medical school admissions candidates. After that, I studied for a while, tutored, hung out with Alex at a local Peet's coffee, and then Alex treated me to a lovely early birthday dinner at a Mexican restaurant in Redwood City called Milagros. Yum!
Thursday, November 17th (my bday!) - Alex made me breakfast in bed, I attended a class, skipped a class to go for a walk around campus, had lunch (was surprised by a friend with a cupcake), attended anatomy lecture/lab (surprised by another friend with a balloon), studied for a bit, and then enjoyed an oh-so-lovely evening with my friends out in Palo Alto. Alex, Liana, Megan, Nicole, Lindsey, and I went to the Crepevine for dinner and I had a delicious greek-style salmon crepe. To follow that, we walked a few blocks over to this lovely wine bar called Vino Locale. It is located in an old house, just a half a block from the Apple Store and has a wonderful, relaxed feel to the place. The walls are covered with vibrant artwork by local artists and the staff are enthusiastic and very friendly. We had reserved the back patio, complete with heaters and blankets and decorated with Christmas lights. The tables set aside for us had candles on them and the owner came out to greet/welcome us. It was so cute. We had the whole patio to ourselves and took full advantage of it. We shared a few bottles of red wine, waited for Kelsey to arrive, and then they surprised me with a cake from a local bakery. (Alex also had a special slice of pumpkin cheesecake - my favorite - brought to me, with the candle lit, and everyone singing the first full rendition of the birthday song I had heard that day) The evening was really, really wonderful! It was nice to relax with my friends and enjoy a very different pace for once. All in all, an amazing bday!
Friday, November 18 - In the afternoon, I had another clinical skills session. This one focused on having conversations with patients about intimate partner violence. I think it was an extraordinarily meaningful session for all of us and I thought it actually went really well, although of course the content was complex and heavy.
Friday evening, Kelsey came over to our place for dinner (roasted zucchini, potatoes, cauliflower, and sauteed chicken). We then went back to Palo Alto to meet up with my classmate Rich (who shares my 11/17/86 birthday) at a bar called Nola's. My whole class was invited to help us celebrate and celebrate the beginning of break and tons of people showed up. I spent hours talking with people and drinking too much of some concoction Kelsey kept providing me with entitled a "Hurricane Bowl." Well Saturday morning, I certainly felt like I had been through a hurricane, so despite the fun festivities of the evening before, I spent all of Saturday leading up to my flight in bed. At about 3:30pm, Alex congratulated me for making it upstairs. Haha, oh the simple joys found in small accomplishments!
Saturday, November 19th - After finally rousing in the late afternoon and mustering the energy/equilibrium to pack, I made it to the airport and by 9:45 that evening I was in Seattle!
I spent the rest of that evening and the next morning reconnecting with my cousin Shannon. We were able to share some nice relaxing time, including a trip to Geraldine's Counter in Columbia City for Sunday brunch and a walk around Seward Park. The Puget Sound weather was beautiful when I arrived. I couldn't have ordered a better reintroduction to the area. A crisp, cool late fall morning, with trees still full of color and tons of snow on the mountains. Love it!
Shannon dropped me off at the ferry in the early afternoon and then I was able to spend the afternoon/evening with my family. I was very ready for the reunion! My mom made me cajun shrimp and grits as a belated birthday celebration and we (Danielle, Chris, Weston, my parents and I) enjoyed some scrumptious homemade pumpkin-marble cheesecake for dessert.
The rest of the week was filled with family time, some academic tasks, and preparations for Thanksgiving. (Monday evening I had another little reunion with my friend Laura - classmate from UPS and fellow rower - which was fantastic and long overdue).
Thanksgiving was incredible and my mom teamed well (as we usually do) to produce an amazing feast. We started on Wednesday - I baked two pies (pumpkin and pecan) and my mom started cranking out multiple batches of rolls (she ended up with 4 types - whole wheat and regular butter flake, sweet potato, and dill-oatmeal rolls). On Thursday, I was responsible for the turkey (orange and mustard basted). The rest of our menu included: roasted brussel sprouts, a roasted vegetable medley (yams, butternut squash, and beets), sausage and apple stuffing, green beans with sauteed mushrooms and slivered almonds, cranberry relish, cranberry sauce, onion-raisin port relish, Waldorf salad, mashed potatoes, and gravy (and probably other stuff I am not remembering). Everything was a hit and Chris ate about half of the pecan pie (this version had a high proportion of pecans and a bit of molasses for an added depth of flavor).
Yesterday, I made a chocolate ganache-sour cherry tart for an evening event with my aunts, uncles, parents, and a few of my cousins. The tart was a success and there were many jokes thrown around about how my family both loves me and my ganache. Fortunately, my identity and that of the ganache I make have not merged yet.
Now, I am preparing to head back to CA and looking back over the week, it has gone by way too fast!! I want to rewind a bit and savor the experiences and the opportunities with family before I am thrown back into a sea of schoolwork and preparations for finals. I have 6 finals ahead of me: one this coming week, one the week after, and then four, back to back, the last week before I am on vacation (for real this time). I can't wait to be free of academic obligation for a bit and not have to wonder how I should be spending my time, whether that means focusing on family or focusing on med school.
In closing, I would like to take a moment to express what I am grateful/thankful for, given the holiday that has just passed. I am thankful for the path that I am on, the institution I am fortunate enough to be a part of, and the phenomenal classmates that will share in the roller coaster-like ride of medical school. I am grateful for the continued support, encouragement, and love of my family and friends, for the inspiration I receive from those most dear to me, from the opportunities before me, and I am very very thankful to share the journey with my dear dear boyfriend Alex.
Let the holiday season begin!
Saturday, November 26, 2011
Sunday, November 13, 2011
What it means to serve...
Another week completed and one more to go before I get a much-anticipated week off from school.
Last week was good. I had imagined that I would have much more time to get things done because Alex is home in Oregon, but turns out, when you have evening commitments, combined with class from 9-5 everyday, there is not much time for getting ahead on homework. :)
Wednesday, I spent much of the day doing miscellaneous errands, such as buying food for my last Healer's Art class or going to a blood-draw visit for a vaccine study I am participating in. I also participated in a simulation study on laparoscopic surgery and tutored, before spending the entire evening in my Healer's Art class.
The laparoscopic surgery simulation was quite something. I had signed up for this study weeks beforehand, having received an email offering to teach participants some surgically related skills and feed them pizza. Thus, when I went to the simulation center in the med school on Wednesday, I had no idea what to expect. I was told that I needed to complete a simple task using laparoscopic tools, picking up rings from six pegs on the left with the tool in my non-dominant hand, transferring the ring to the tool in my dominant hand and dropping the ring on a peg on the right half of the board. I had to do that for each of the six rings on the left and then do the reverse. They videotaped me, timed me, and then sent me into a room where I received feedback from a surgeon. During the task, I was excited. I had never done this before, but I was up for the challenge, plus I am genuinely curious about surgery, so this felt like a good opportunity to try something related to the field. I felt like I did pretty good job executing the task. Therefore, I was quite surprised when I received feedback from the surgeon that I had performed among the lowest of my peers (first-year med students with no prior experience), he reminded me of the validity of this type of task and predicted surgical aptitude and he thought that knowing my low performance could be helpful in future decision-making.
I was stunned! Dumb-founded! I just stared at him with complete disbelief. After he spoke, I was relocated to the "break room" where the was deep-dish pizza and snacks. I was so so bummed. I had a half an hour to kill before I was supposed to do the task again and I was just thinking - "Why on earth did I volunteer for this study? I don't need this, I want to decide whether surgery is right for me on my own terms, not because of a task I completed as part of a simulation study." There were a few of my classmates in the same room, but we were not supposed to discuss the study. Long story short, I learned after completing the task again that the point of the study was to explore the impact of positive/negative feedback on subsequent performance. I was the kind of guinea pig they wanted - I completely bought their story! I was so relieved after the 'ruse' was revealed that I got tears in my eyes. The surgeon who had given me the feedback purposely sought me out to reassure me that I actually had done quite well, because, although I had been silent, he could tell that I was quite upset by the feedback I had received.
A complete emotional roller-coaster all in one hour's time. Crazy! It's a good story to tell now though.
My Healer's Art class Wednesday evening served as a wonderful ending to my otherwise busy and bemusing day. To close this incredible class series, we started with some scrumptious Mediterranean food (which I ordered from a great family run restaurant in Palo Alto - the owner actually recognized me when he dropped the food off, based on the 2 whole times I have come by his place, ordered hummus and pita, and sat outside to enjoy it - I was always given complimentary tea and falafel which was a treat). After our dinner, we immediately broke into our small groups and had a chance to share what this class has meant to us. One common theme: it reminded all of us how much depth each person that we interact with in passing has, there is so much to know about a person and we tend to overlook that depth and that richness even with those people we work with day after day after day. I felt a great connection to my small group members and I felt honored to have had the chance to get to know them better. I think the shared experience fostered by the Healer's Art class will be carried with all of us for a long time coming. We are already planning the reunion!
After small group time, we came back together - all 22+ of us - and we had time to contemplate what devoting your life to service through medicine really means, not only to the field, but to us individually. Our instructor spoke of us having a job that does not inform how we live, but instead allows us to express our highest values every day. The messages he reiterated about service and compassion and improving yourself through work that upholds those two values was an great inspiration. I felt uplifted by the energy in that room. Just being amidst such an amazing group of motivated, talented, and truly humble aspiring physicians was something I won't be able to replicate any time soon.
At the very end, we wrote statements of service and read them allowed, repeating our statement to let the words sink in, before the next person read theirs. Each person lit a small votive after sharing their words and placed the votive in the center of the room. The room was dark and a "talking candle" was passed from person to person, serving as the spark for each of our messages of service.
Mine was as follows:
Strengthen me to give to others with love and without pause, to listen not judge, and to care for all who seek my help as I would care for those most dear to me. Empower me to embrace the diversity I see in the people I meet and to stand as a fierce advocate for the underprivileged, no matter the obstacles. Enable me to nurture my role as a physician while also nurturing my role as a friend, partner, daughter, sister, mother, mentor and teacher. Remind me to resonate with the meaning in all that I do and live with no regrets.
It was a powerful evening to say the least. I noted other immensely moving things expressed by my classmates, many of which I connected with at my core. Other key things I took away were the concepts of living without self-consciousness and defining success in my own terms. I felt empowered and ready to tackle the next 5-10 years of training with gusto. :)
To top of the whole night, we had an ice cream party. Perfect!
The rest of my week couldn't really compare to that. Although I did have a lovely wine tasting date with my classmate Lindsey on Thursday evening, followed by a SWEAT orientation reunion dinner at a Palo Alto Thai restaurant called Thaiphoon. Delicious!
Friday was stormy here and I took advantage of that to try and get some work down on Friday night. Not the most exciting way to spend one's Friday evening, but boy was I productive!
Saturday morning I baked pumpkin-bran-coconut-walnut-millet-dark chocolate chip cookies and then went tailgating for the big Stanford-Oregon game. I met up with a bunch of my classmates there, handed out cookies, found out that I get to be the lead planner of next year's Stanford Med outdoor orientation (yipee!) and then watched Stanford play a game somewhat akin to football (still can't quite put my finger on it).
The game was a huge disappointment, the entire stadium seemed to grieve the poor performance of their undefeated team, although there was a large contingent of ducks fans who were living it up! I left the game early and went out for sushi and frozen yogurt with Liana and Megan.
Today was BUSY. I worked at the free clinic for the first half of the day, which was a phenomenal experience per usual. The clinic was swamped with patients (i.e. plenty of students to see the patients, but not enough physicians), so I only saw one patient, but again I was able to have a cross-cultural exchange with an older Chinese woman whose daughter accompanied her to translate Mandarin. The afternoon was all tutoring, then studying, and here I am - about to start another week and then launch myself northward.
The weeks continue to be rich, but full. I am anxiously anticipating next week, which will also be rich in a different way and I know that when 11/24 rolls around, I will certainly be full!!
T-6 days and counting!!!
Last week was good. I had imagined that I would have much more time to get things done because Alex is home in Oregon, but turns out, when you have evening commitments, combined with class from 9-5 everyday, there is not much time for getting ahead on homework. :)
Wednesday, I spent much of the day doing miscellaneous errands, such as buying food for my last Healer's Art class or going to a blood-draw visit for a vaccine study I am participating in. I also participated in a simulation study on laparoscopic surgery and tutored, before spending the entire evening in my Healer's Art class.
The laparoscopic surgery simulation was quite something. I had signed up for this study weeks beforehand, having received an email offering to teach participants some surgically related skills and feed them pizza. Thus, when I went to the simulation center in the med school on Wednesday, I had no idea what to expect. I was told that I needed to complete a simple task using laparoscopic tools, picking up rings from six pegs on the left with the tool in my non-dominant hand, transferring the ring to the tool in my dominant hand and dropping the ring on a peg on the right half of the board. I had to do that for each of the six rings on the left and then do the reverse. They videotaped me, timed me, and then sent me into a room where I received feedback from a surgeon. During the task, I was excited. I had never done this before, but I was up for the challenge, plus I am genuinely curious about surgery, so this felt like a good opportunity to try something related to the field. I felt like I did pretty good job executing the task. Therefore, I was quite surprised when I received feedback from the surgeon that I had performed among the lowest of my peers (first-year med students with no prior experience), he reminded me of the validity of this type of task and predicted surgical aptitude and he thought that knowing my low performance could be helpful in future decision-making.
I was stunned! Dumb-founded! I just stared at him with complete disbelief. After he spoke, I was relocated to the "break room" where the was deep-dish pizza and snacks. I was so so bummed. I had a half an hour to kill before I was supposed to do the task again and I was just thinking - "Why on earth did I volunteer for this study? I don't need this, I want to decide whether surgery is right for me on my own terms, not because of a task I completed as part of a simulation study." There were a few of my classmates in the same room, but we were not supposed to discuss the study. Long story short, I learned after completing the task again that the point of the study was to explore the impact of positive/negative feedback on subsequent performance. I was the kind of guinea pig they wanted - I completely bought their story! I was so relieved after the 'ruse' was revealed that I got tears in my eyes. The surgeon who had given me the feedback purposely sought me out to reassure me that I actually had done quite well, because, although I had been silent, he could tell that I was quite upset by the feedback I had received.
A complete emotional roller-coaster all in one hour's time. Crazy! It's a good story to tell now though.
My Healer's Art class Wednesday evening served as a wonderful ending to my otherwise busy and bemusing day. To close this incredible class series, we started with some scrumptious Mediterranean food (which I ordered from a great family run restaurant in Palo Alto - the owner actually recognized me when he dropped the food off, based on the 2 whole times I have come by his place, ordered hummus and pita, and sat outside to enjoy it - I was always given complimentary tea and falafel which was a treat). After our dinner, we immediately broke into our small groups and had a chance to share what this class has meant to us. One common theme: it reminded all of us how much depth each person that we interact with in passing has, there is so much to know about a person and we tend to overlook that depth and that richness even with those people we work with day after day after day. I felt a great connection to my small group members and I felt honored to have had the chance to get to know them better. I think the shared experience fostered by the Healer's Art class will be carried with all of us for a long time coming. We are already planning the reunion!
After small group time, we came back together - all 22+ of us - and we had time to contemplate what devoting your life to service through medicine really means, not only to the field, but to us individually. Our instructor spoke of us having a job that does not inform how we live, but instead allows us to express our highest values every day. The messages he reiterated about service and compassion and improving yourself through work that upholds those two values was an great inspiration. I felt uplifted by the energy in that room. Just being amidst such an amazing group of motivated, talented, and truly humble aspiring physicians was something I won't be able to replicate any time soon.
At the very end, we wrote statements of service and read them allowed, repeating our statement to let the words sink in, before the next person read theirs. Each person lit a small votive after sharing their words and placed the votive in the center of the room. The room was dark and a "talking candle" was passed from person to person, serving as the spark for each of our messages of service.
Mine was as follows:
Strengthen me to give to others with love and without pause, to listen not judge, and to care for all who seek my help as I would care for those most dear to me. Empower me to embrace the diversity I see in the people I meet and to stand as a fierce advocate for the underprivileged, no matter the obstacles. Enable me to nurture my role as a physician while also nurturing my role as a friend, partner, daughter, sister, mother, mentor and teacher. Remind me to resonate with the meaning in all that I do and live with no regrets.
It was a powerful evening to say the least. I noted other immensely moving things expressed by my classmates, many of which I connected with at my core. Other key things I took away were the concepts of living without self-consciousness and defining success in my own terms. I felt empowered and ready to tackle the next 5-10 years of training with gusto. :)
To top of the whole night, we had an ice cream party. Perfect!
The rest of my week couldn't really compare to that. Although I did have a lovely wine tasting date with my classmate Lindsey on Thursday evening, followed by a SWEAT orientation reunion dinner at a Palo Alto Thai restaurant called Thaiphoon. Delicious!
Friday was stormy here and I took advantage of that to try and get some work down on Friday night. Not the most exciting way to spend one's Friday evening, but boy was I productive!
Saturday morning I baked pumpkin-bran-coconut-walnut-millet-dark chocolate chip cookies and then went tailgating for the big Stanford-Oregon game. I met up with a bunch of my classmates there, handed out cookies, found out that I get to be the lead planner of next year's Stanford Med outdoor orientation (yipee!) and then watched Stanford play a game somewhat akin to football (still can't quite put my finger on it).
The game was a huge disappointment, the entire stadium seemed to grieve the poor performance of their undefeated team, although there was a large contingent of ducks fans who were living it up! I left the game early and went out for sushi and frozen yogurt with Liana and Megan.
Today was BUSY. I worked at the free clinic for the first half of the day, which was a phenomenal experience per usual. The clinic was swamped with patients (i.e. plenty of students to see the patients, but not enough physicians), so I only saw one patient, but again I was able to have a cross-cultural exchange with an older Chinese woman whose daughter accompanied her to translate Mandarin. The afternoon was all tutoring, then studying, and here I am - about to start another week and then launch myself northward.
The weeks continue to be rich, but full. I am anxiously anticipating next week, which will also be rich in a different way and I know that when 11/24 rolls around, I will certainly be full!!
T-6 days and counting!!!
Wednesday, November 9, 2011
You know its fall when...
Happy November everyone! This is my favorite month, partly because I love fall, partly because I love birthdays, and mostly because I LOVE Thanksgiving! I am now in a 10 day countdown until I fly back to the Northwest for a week off from school. I am excited!
Since Halloween, when I last posted, my classwork has been pretty routine and my evenings have been filled with studying and completing homework assignments. This past weekend, I was able to hang out friends and make homemade butternut squash soup and bread. Making bread made me particularly happy. Not only because Saturday was an overcast day, so the smell of baking bread and the relaxing pace of a football-watching afternoon were well matched, but this was the first time I had baked bread since moving to California. For me, that says something. I love baking bread! When Alex and I last lived together I made bread at least weekly. At that time, I was nurturing a sourdough starter and I doubt we ever bought a loaf of bread that entire year. So, it was about time that I figured out a way to safeguard an afternoon from other commitments and make some bread! The whole culinary endeavor turned out wonderfully. :)
Other highlights of the past week stem from my clinical skills sessions where I interview standardized patients. The session for last Friday was titled the "Challenging Patient Encounter." Such a grand title certainly made it so me and many of my classmates were a little nervous about what exactly we would experience with our patients. Fortunately, I did not go first amongst my triad. My first group member had an older woman who would not stop talking! She lived alone, her husband had died somewhat recently, and she was experiencing numerous symptoms all of which she would describe while also telling a portion of her life story. As an outsider it was almost humorous to watch, but for my classmate it was very challenging to figure out how to tactfully interrupt her and guide the conversation.
My patient was an older man who presented with a persistent cough and he was convinced he needed a prescription for antibiotics. He stated that he had been diagnosed with bronchitis two years ago and that his doctor had not prescribed anything, so he took some leftover antibiotics from one of his friends and that had seemed to work wonders. I acknowledged all of that, gathered more information from him, and proceed to take a more thorough history. Meanwhile, I was thinking to myself, What is challenging in this patient? What am I missing? Because of the way the clinical skills session had been set up, I was worried that I was completely overlooking something. The interview went well and when debriefing with my group I learned that the patient's desire for antibiotics was supposed to be the challenge, but rather than let it be an issue, I deferred the responsibility of determining whether the antibiotic was appropriate for the patient at this time to my supervising physician. The entire encounter was surprising to me, but successful nonetheless.
On Monday of this week, we had another clinical skills session, this time revolving around third-party interviewing (interviewing with a third party present - such as a caregiver, interpreter, etc.). In our room, we had three stations with language interpreters and one with a man suffering from dementia and his caregiver (a daughter). I ended up interviewing a young woman experiencing abdominal pain who communicated with American Sign Language. While I worked with an interpreter two weeks ago at the free clinic, this was completely different. The pace of sign language is slower and I had to learn how to adjust my questions and the tempo of my speech to allow for a smoother experience. This was all done on the fly, so I found the encounter much more challenging, but I was so happy to have been thrown into that kind of experience and see what I could do. We only had 10 minutes for the interview, which flew by amidst all of the necessary interpretation. I think that session was a favorite among my classmates. It required all of us to step up and take some risks, but we also came away with real tangible lessons that will easily translate to future patient visits.
This week, I am on my own at home. Alex is in Oregon helping to take care of his mom who is recovering from her second hip replacement surgery and I am going to try and capitalize on some alone time to get a jump start on studying and lower the amount of work I will need to do while up on Whidbey over the Thanksgiving holiday.
Life outside of school is good. I am grateful to have established a pretty solid group of friends already and I am beginning to embrace the notion that the Palo Alto area will be 'home' for the next few years of my life. For some reason, accepting that this transition is more than a temporary experience is taking a while for me. I do miss the turning of the seasons that one feels much more in other parts of the country, but the evenings have begun to get much cooler here and I am occasionally having to bring layers to accommodate the larger swing in temperatures (mid 60s in the day to mid 40s in the evening). I am someone who loves bundling up, so crisp evenings and mornings are a welcome occurrence!
This week, I have a reunion dinner on Thursday with the group I went backpacking with during orientation and the highlight of the weekend will be the big football game between Stanford and Oregon. Should be fun!
I will give a recap of the weekend's festivities Sunday evening or Monday morning hopefully. :)
Big hugs to all!
Since Halloween, when I last posted, my classwork has been pretty routine and my evenings have been filled with studying and completing homework assignments. This past weekend, I was able to hang out friends and make homemade butternut squash soup and bread. Making bread made me particularly happy. Not only because Saturday was an overcast day, so the smell of baking bread and the relaxing pace of a football-watching afternoon were well matched, but this was the first time I had baked bread since moving to California. For me, that says something. I love baking bread! When Alex and I last lived together I made bread at least weekly. At that time, I was nurturing a sourdough starter and I doubt we ever bought a loaf of bread that entire year. So, it was about time that I figured out a way to safeguard an afternoon from other commitments and make some bread! The whole culinary endeavor turned out wonderfully. :)
Other highlights of the past week stem from my clinical skills sessions where I interview standardized patients. The session for last Friday was titled the "Challenging Patient Encounter." Such a grand title certainly made it so me and many of my classmates were a little nervous about what exactly we would experience with our patients. Fortunately, I did not go first amongst my triad. My first group member had an older woman who would not stop talking! She lived alone, her husband had died somewhat recently, and she was experiencing numerous symptoms all of which she would describe while also telling a portion of her life story. As an outsider it was almost humorous to watch, but for my classmate it was very challenging to figure out how to tactfully interrupt her and guide the conversation.
My patient was an older man who presented with a persistent cough and he was convinced he needed a prescription for antibiotics. He stated that he had been diagnosed with bronchitis two years ago and that his doctor had not prescribed anything, so he took some leftover antibiotics from one of his friends and that had seemed to work wonders. I acknowledged all of that, gathered more information from him, and proceed to take a more thorough history. Meanwhile, I was thinking to myself, What is challenging in this patient? What am I missing? Because of the way the clinical skills session had been set up, I was worried that I was completely overlooking something. The interview went well and when debriefing with my group I learned that the patient's desire for antibiotics was supposed to be the challenge, but rather than let it be an issue, I deferred the responsibility of determining whether the antibiotic was appropriate for the patient at this time to my supervising physician. The entire encounter was surprising to me, but successful nonetheless.
On Monday of this week, we had another clinical skills session, this time revolving around third-party interviewing (interviewing with a third party present - such as a caregiver, interpreter, etc.). In our room, we had three stations with language interpreters and one with a man suffering from dementia and his caregiver (a daughter). I ended up interviewing a young woman experiencing abdominal pain who communicated with American Sign Language. While I worked with an interpreter two weeks ago at the free clinic, this was completely different. The pace of sign language is slower and I had to learn how to adjust my questions and the tempo of my speech to allow for a smoother experience. This was all done on the fly, so I found the encounter much more challenging, but I was so happy to have been thrown into that kind of experience and see what I could do. We only had 10 minutes for the interview, which flew by amidst all of the necessary interpretation. I think that session was a favorite among my classmates. It required all of us to step up and take some risks, but we also came away with real tangible lessons that will easily translate to future patient visits.
This week, I am on my own at home. Alex is in Oregon helping to take care of his mom who is recovering from her second hip replacement surgery and I am going to try and capitalize on some alone time to get a jump start on studying and lower the amount of work I will need to do while up on Whidbey over the Thanksgiving holiday.
Life outside of school is good. I am grateful to have established a pretty solid group of friends already and I am beginning to embrace the notion that the Palo Alto area will be 'home' for the next few years of my life. For some reason, accepting that this transition is more than a temporary experience is taking a while for me. I do miss the turning of the seasons that one feels much more in other parts of the country, but the evenings have begun to get much cooler here and I am occasionally having to bring layers to accommodate the larger swing in temperatures (mid 60s in the day to mid 40s in the evening). I am someone who loves bundling up, so crisp evenings and mornings are a welcome occurrence!
This week, I have a reunion dinner on Thursday with the group I went backpacking with during orientation and the highlight of the weekend will be the big football game between Stanford and Oregon. Should be fun!
I will give a recap of the weekend's festivities Sunday evening or Monday morning hopefully. :)
Big hugs to all!
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