My First Real Patient

Kendra Campbell -- I finally took my first trip to a hospital since I started med school. Several students and I went to a small hospital, located a few miles from our campus. It only had 11 beds, but almost all of them were filled with a variety of patients. I’ve spent many years in hospitals as a psychiatric technician, and as a volunteer, and even once or twice as a patient, but this was my first time in a hospital as a medical student. I actually wore my white coat and toured all the rooms with the doctor who ran the hospital. Now, I know for all you seasoned med students and physicians out there, this might not seem like a big deal, but it certainly was for me!

We first went around with the doctor from room to room, and he described each patient’s case and asked us various questions about the anatomy and pathology of their conditions. I was so thrilled to actually be applying the information that I’d previously only used to fill in multiple-choice answers on exams. I was surprised and elated to find that I could answer many of the questions that he asked! At one point, as we were examining a patient with a hydrocele of his testis, the doctor pulled out a cardboard box containing a few specimen containers. He nonchalantly opened the specimen container and pulled out a testicle that had been removed from a previous patient. As he pointed to the epididymis and described how enlarged the testicle had become, I was filled with enthusiasm! It might seem strange, but finally I could apply my knowledge of anatomy to answer real questions about real patients! Yes, I know that I am a huge dork. (But I have a suspicion that there are many of you out there that felt the same way the first time.)

After we toured the hospital, each of the students was assigned a patient to perform a full history on. This being the first time that I had taken a history from a real patient, I was a little nervous, but after introducing myself and talking to the patient for a few moments, I felt completely at ease. As I took the woman’s history, I tried to remember all the relevant questions that I had learned to ask. I found myself blanking a few times, but I remembered to ask most of the important questions.

After finishing the history, I re-joined the group, and our attending physician asked each of us to give a presentation of our patient. Since no one else would volunteer to go first, I agreed to begin. I wasn’t exactly sure how to present the case, or which order to go through the information. And I was surprised to find myself nervous when standing in front of the physician and fellow med students while giving my presentation. I know I made a million mistakes, but that was actually the point. The attending told me that I did a pretty good job, though I mixed up the order of a few items. I was so relieved once it was all over, even though I realized that I had missed a few questions that I should have asked the patient.

I’m beginning to see that my previous experience working in hospitals is quite advantageous, but I still have a lot to learn about being a good history taker. I’ve seen many histories performed, and I know all the questions to ask, but I now realize that once you’re faced with your patient, it’s easy to forget everything you know! I’m so delighted, though, about actually interacting with real patients and learning their stories. I still have very far to go, and a lot to learn, but I couldn’t be more excited about the long road ahead!