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!
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