TEN MORE DAYS.
That's what's separating me from now and freedom. Well, freedom from anatomy. Biochemistry is right around the corner but we won't talk about that right now. Just ten days. Granted, I gotta take two different tests in this ten-day span but at this point I don't even care. I've finally developed a study groove in anatomy and I plan on finishing strong. Bring on test #4. Bring on that CAS Cumulative Final Exam. Speaking of which, who's idea was it to have a cumulative final exam on 12 weeks of jam-packed anatomy FOUR DAYS AFTER our fourth exam?? Like, how could someone possibly cram details of the whole body in four days, especially right after taking an exam? I don't know what kind of games they playing or what they're smoking. But it's gotta be done. So this is what I'm going to do. I'll give it my all once again on my next exam this Friday and then I won't stress about the final. Sure I'll study during the four days before it, but I'm not going to kill myself over it. As a matter of fact, I'll mix some Bernie Mac Show, Netflix movies, college football and FIFA into my studying. That's the beauty of pass/fail y'all. If I do decent enough on the test before my final, I don't have to worry about scoring high. Shiii, it may even be possible to score a zero on the final and still pass the class. Granted, I'm not scoring a zero…I literally won't allow myself to tank a test on purpose lol. But I also won't spend 18 hours a day trying to digest material that I spent the last 11 weeks learning at an accelerated pace. You see, I'm convinced they're playing mind tricks y'all. Alongside learning the art of medicine, I'm convinced some of the faculty wanna see us stress and struggle as well as observe how we handle all the stress they put on us. They not gonna stress me tho! No suhhh, NOT ME!! I'm really about to be on that “work smarter, not harder” grind during the four days before the final. They really got me all f-ed up if they think ima be posted in the library studying till 6 AM like it was the USMLE Step 1 exam.
So yeah, ten more days and I'm done with anatomy. It's come to the point where I'll be unconsciously naming muscle groups in my head while I'm lifting weights. I even go as far as trying to figure out what arteries and nerves supply the muscles I'm working on. That's when you know it's gone too far. Anatomy has taken over my life y'all. 😳 If I had this same study mentality in college, I know for a fact that I would've gotten summa cum laude. But I also had a much bigger social life in college, and I wouldn't give that up for the world lol. Enough about anatomy. In regards to the practical skills that I will actually use as a doctor, I'm finding that I'm starting to feel more confident in patient interviewing. I don't know what it is about taking a patient's history, but I was having a good amount of trouble at first trying to keep a conversation flowing while remembering what specific questions to ask and how to specifically ask them. So I ended up getting additional practice with my clinical skills coaches, because although I've been told my personality has been helping me with my patients, my patient interviewing skills were pretty sub-par. Which means your boy can only go up from here and shoot for Most Improved! The more I practice patient-interviewing, the more I realize that the whole process is a game, in a way. You see, you gotta go in there hella confident and have the purpose of getting the patient to trust you while you are getting to know the patient. Confidence is key because even if you are only four months into medical school, the patient is going to see you as a doctor of some sort since you have a white coat on. Then as you're learning from the patient, you gotta hit the key points of the interview:
- When did your symptoms first start?
- How long have you been dealing with your pain?
- Where exactly is the pain located/Where is the pain radiating?
- How would you describe the pain? (Quality of pain)
- On a scale of 1-10, how bad is the pain? (Quantity/Severity)
- What are some activities that alleviate the pain?
- What are some activities that aggravate the pain?
- What are some associated symptoms of your condition?
- How is the pain impacting your quality of life?
- What were you doing when you first noticed the pain?
- Have you had any past experiences with your current condition?
And each time questions are answered in the interview, you get points. The more points you get, the better your chances of winning the game when you have to give a patient presentation. Trick is, you have to ask these questions without coming across as cold or disassociated from the patient's emotions. You have to let the patient have some control over the interview and show them that you care if you want to get as much information as possible. But you see how hard it is to remember all that while trying to hold a regular conversation with the patient?? Okay maybe you don't, but I found it very challenging. And that's just the history-taking portion! In real life, I'll have to do a physical exam, a separate family and social history, a past medical history, a review of systems and a treatment plan.
I think my problem was that I gave the patient way too much time to talk about his/her life and that I couldn't necessarily redirect the interview to where I needed it to go. Hell, the last two patients I interviewed ended up crying mid-way thru the conversation. That's where my empathy skills shined bright. It goes to show how human the patients are and how as doctors we have to remember that we are treating more than a disease; we're treating a human being with a disease that is impacting his/her overall life. I definitely plan on keeping my empathetic skills strong, and I'm glad to say that I've been recently doing better gleaning vital information from the patients I've been interviewing. As a matter of fact, one of the patients I interviewed made me promise to her that I would keep my bedside manner and active listening skills as I grow into a doctor. So I intend on keeping that promise.
I mentioned patient presentations earlier. That's when you go to your team and present to them the information you got from the patient. I had to do that for the first time last Thursday and mannn was that a challenge. My clinical skills coach didn't even give me time to gather my thoughts 😐. There's actually a certain way you have to present patients and the presentation comes with certain terminology. I was forced to think quick and use the notes I hastily scribbled down during the interview to come up with a presentation. I'm not sure if that's how patient presentations work though, I could have sworn doctors had more time to organize their notes before presenting…
Oh and I am also currently learning how to do patient write-ups, which is where we write a formal description of the patient that includes the answers to all the questions that we asked them in the history-taking portion of the patient interview. The overall write-up also includes the other parts of the patient encounter such as the physical exam review, the family and social history, the past medical history, the review of systems and the treatment plan for the patient. But we're taking baby steps right now, so I've only done the HPI (history of present illness), family/social history and review of systems portions. I thought it was simple enough to write a description of the patient, but I've been ripped both times I've submitted a write-up so far lol. I'm not sure if my coach is just being hard on me or if my write-ups actually suck, because I genuinely thought I was doing a good job on those. 😅 Well we all gotta start somewhere right? I'd rather suck and learn valuable advice now than go into my third-year with no prior clinical experience. Shoutout to Wake for having us interact with patients often throughout our first two years of medical school, this experience is really helping me out.
Alright, I'm finished.
Thanksgiving needs to hurry on up and get here.
Have an incredible week everyone! Stay positive and focused on your goals! Be blessed!
– Black Man, M.D.
P.S. Shoutout to everyone back in Miami that got tapped into Iron Arrow!! I was very excited to see all of the new members of the tribe! I wish I was there for the tappings and for Homecoming…nevertheless, Welcome to the Tribe! Y'all deserve it!!!