A while back...

Back in Miami I saw a patient in the local homeless shelter clinic. All he was complaining about at the time was his headache, but since he was the only person I was there to see we talked for an hour or two. Back when he was young he used to sell drugs which lead to him being sent to prison. When he got out he started hooking up with several different women in the area. He estimates that it is one of these trysts that lead to him contacting HIV. His life since then has consisted of more crime, drug addiction, more sex, and failing health.
The first thing that stuck out to me was the depression*. Now, depression is sadly common among people with HIV/AIDS but this man described it differently than I had heard it before. He talked about his fellow residents at the homeless shelter, how they were dirty, how they were rude, how he could imagine their germs attacking him, how he loathed being around them. "And yet," I thought to myself, "How many of these other men have the same or similar stories as this man?**" Maybe that's what Hell is, being forced to be around the people we are most like. Then again, depending on how good you've been, maybe that's heaven.
The second thing that struck me was what a good time he seemed to be have despite all of his troubles. For these two hours I gave more to this man than acetaminophen, I gave him the chance to talk to a friend.


* None of the stuff I mentioned has anything to do with the clinical signs of depression
**It would be terribly unfair to generalize that the homeless are all drug addicts, rude, infected with HIV, etc. The analogy I made was meant to be taken philosophically, not literally.

Second clinical experience, a second to remember some great wisdom

My second hospital visit was not all that memorable. I did rediscover a problem I remembered from my days of volunteering in the ER: Standing around all day is unpleasant. I keep thinking there is some secret club of doctors and nurses who have found the “uber-shoe” that makes standing around interviewing patients for hours more enjoyable than soaking your toes in cool lake on a hot day. Still no luck finding the comfort cult. Let me know if you hear any chanting in your local hospital, “We love our shoes, our shoes are our pals”

There is a certain type of person that tends to reject everyone else’s ideas while simultaneously rejecting all attempts to constructively suggest (I’m serious) that they might, in fact, be mistaken in this case. I heard once that in Japan among social equals it is rude to tell someone that they are wrong. The common response to something incorrectly spoken is to rely, “That is also an answer.”

I met someone this week who is the often the “certain type of person”. In the moment I let it bother me, but now I remember some my father told me once:

“Son, sometimes you have to let some people be right, because for some people that’s all they have.”

My first visit to the hospital as a medical student

In our second year of medical school we get the chance to visit a local hospital and perform some "real" interviews and physical exams. Of course, the patients have already been interviewed by actual doctors and their physical exams already completed. Regardless, it felt much more genuine than being in a classroom interviewing someone who was invited to come and tell us about their illness.
Our group was a little too excited to get to the physical exam, and I'm sorry to say that I skipped a few of the initial steps. It wasn't too bad. Dr. "I don't shake hands", who was our instructor for the morning, made it a memorable enough experience for us all that I don't expect to be forgetting again any time soon.
In the afternoon we got into a group of five and interviewed a gentleman who had a back injury. I got my first "Yeeeaaaoooww!" reaction while palpating his left kidney. He was in some real pain. I felt bad.
Upon reflection, (because that's what bloggers do right?) It seems that in my career as a physician I will continue to cause pain (poking people with needles, giving them noxious medication, eliciting pain responses, etc.) all in the name healing or obtaining the information I need to heal. A nurse friend of mine once told me that many of the things they do to patients are extremely painful and might be called torture if it was under different circumstances. I imagine he was referring to something like changing the bandages of a burn wound victim or like procedure.

I guess "Do No Harm" doesn't necessarily mean "Cause No Pain". It's probably why so many people are afraid of doctors: Sometimes the cure hurts.

...but you're not a doctor!

Yeah, so I'm not really a pro at this whole blogging thing. I just threw the "doc" part in their because
1) I eventually will be a doctor
2) I naively don't know if you can change the name without losing any of the posts.

I wanted to write a little about my first real clinical experience but due to some inclimate weather our trip was cancelled. Better luck next time.

Today is the First Day of the Rest of Your Blog

I'm not a Doctor. I'm a medical student. There is a difference. If you remember your SATs:
A doctor is to a medical student what a major league baseball player is to a _________?

A: Minor Leaguer
B: College Player
C: High School Player
D: Bat Boy

I guess my answer can change on any given day.

I am starting this blog to have a place to put down some experiences as I get ready for clinical rotations and eventual life as a physician.