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Playing Doctor
Kendra Campbell -- I finally got what I asked for. I’ve entered into the clinical years of my medical education. Today, I started learning how to do a physical exam. We only began with the basics: learning how to greet the patient, do a general survey, and take vital signs. As my fellow students and I sat in a half circle around the patient, our professor talked about things we should be paying attention to, such as how the patient is sitting and even the clothes they’re wearing. We all sat around in our “professional” attire, white coats and black bags full of instruments, of which most of us barely even knew the names.
Up until this point in med school, I’ve had no reason to get dressed up. Since I live on a tropical island and the nicest restaurant I visit is a sub shop, I never have the occasion to wear anything more than a pair of shorts, a tank top, and some flip-flops. As I mentioned before, since I haven’t had any real patient interaction, my white coat has been collecting dust in my closet for eight months. I’ve opened my black bag to use my stethoscope and sphygmomanometer to take some innocent bystanders’ blood pressures, and I’ve smacked my boyfriend a few times with my reflex hammer (don’t even get him started about the time I decided to do caloric stimulation on him and poured cold water in his ear). But other than that, I haven’t really done much in the realm of what I’ll eventually be doing every day as a doctor.
So, today as I sat all dressed up in my white coat with my stethoscope hung proudly around my neck, I must admit that I felt pretty strange. I thought that doing real “doctor stuff” would make me feel like more of a real doctor. But oddly enough, it actually made me feel like more of a fake doctor. As I listened to the real doctor spout off every characteristic of the pulse that one is supposed to take note of when taking the vital signs, I felt a wave of inferiority wash over me. Right now, I can’t tell the difference between a bisferiens pulse and a pulsus alternans. Actually, I don’t even know how to correctly pronounce them!
When it was time for me to approach the patient, I felt like a little kid standing in front of my patient in a big white coat. I wasn’t a real doctor; I was just dressing up in my mom’s oversized doctor clothes. As I fumbled to find my patient’s carotid pulse, I imagined the sleeves of the coat dangling over my fingers and making me clumsy and incapable of finding the pulse.
I eventually made it through the exam without falling over or poking a hole in my innocent patient’s neck, but it certainly didn’t go as I had imagined it would. I sincerely hope that I only felt this way because I’m just beginning to actually learn about the hands-on side of being a doctor. I wonder if any of you med students or physicians out there has ever had this happen to you. Am I the only one who’s ever felt like they’re just playing doctor?
May 23, 2007 in Kendra Campbell | Permalink
Comments
Kendra...this is SOOOO totally normal! I'm a 3rd year student, and while I am actually supposed to poke holes in the patient sometimes, a little (OK, kindof a big) part of me still worries about making them bleed when I'm not supposed to or putting something in the wrong hole and having to explain it to my patient and my attending!
I've had friends of mine who are physicians tell me that in all honesty they still feel like they're faking it on the inside...but that's what you do!
Fake it 'till you make it...and thankfully (for once) this process of training is SUPER long so we have lots of time to safely make mistakes before we're supposed to do right by our patient's all on our own!
Congrats on crossing another milestone...it only gets better after 2nd year!
Posted by: Jeremy | May 23, 2007 1:57:36 PM
The biggest lie in medical school " Congratulations! The hardest part is over!!"
Posted by: PassMRCP | May 24, 2007 3:01:16 AM
OMG...clinicals!!
*slobbers and seethes with jealousy*
Posted by: The Angry Medic | May 24, 2007 5:10:59 AM
you definitely NEED to learn to fake it. I don't know for how long it will be till one GETS it, but until then, you're still going to be seeing a lot of patients.... and the thing you need to work on, is try and make the patient feel that they're speaking to and being examined by a "real" doctor. In their place, wouldn't you want a good doctor treating you, and not someone who seems like they have no idea what they're doing? Or forget about for yourself, imagine your parents, or grandparents... You definitely do NOT want some amateur practicing on them, right?
You need to reassure your patients by the way you speak to them and examine them. Practice on your friends first, make sure your skills are reasonably polished before you see genuinely sick people!
Posted by: yasmin | May 24, 2007 10:41:45 AM
Hi Kendra,
I am currently a premed at UC Davis in California planning on attending medical school in the caribbian. I am excellent student, and I have perfomed quite well academically as well as on my MCATs. However, due to working throughout school my GPA is sub-par. With med school admissions as competititve as they are I fear I won;t be able to get into med school in the states, but I don't want to let that fear get in the way of my life dream of becoming a doctor.
I stumbled across your blog by accident, and I thought you might have some interesting words of advice or encouragement. How is med school in the caribbean? Where are you doing your rotations?
Thanks for the help and best of wishes in medicine.
Anthony H
awherren@comcast.net
Posted by: ANTHONY | May 26, 2007 2:24:12 PM
Hi Kendra,
I have been following your blogs since they began and I have thoroughly enjoyed your experiences. I just graduated from med school in the carribean as well, and let me tell you, it is a growing experience. I felt the exact same way you did when I first picked up my stethescope and blood pressure cuff and it still feels wierd. Clinicals will help you in this regard---you will get more and more comfortable as you get through it---some things you forget, other things you remember and others you review with the help of a good attending or resident. I really noticed the difference between a great teacher and a sub-par one who was only interested in themselves and would rather have you sink than swim. But don't get discouraged, it's all a part of the learning experience, and don't be afraid to ask if you don't know---some teachers will appreciate it, others will humiliate you---but in the end, you learn what to do and what not to do.
I'm sure when I step into those 'resident' clothes, my feet will be trembling and my hands tense, but after 4 years of long, hard work, being committed to service is the ultimate reward. Good luck to you and keep going---you are helping a lot of people with your support.
Adil
Posted by: Adil | May 30, 2007 7:14:18 AM
Hi Kendra!
I'm currently a 4th-nearly-5th-semester med student in Mexico and this semester we started practicing on patients and doing clinical histories. I can tell you that's exactly how I feel when i approach a patient and i'm supposed to get all his data. I get confused with all the kinds of pulses and breathings and all that stuff.. Doing the physical exploration part is the time when i feel most stupid, since i'm afraid i'm gonna hurt the patient or make him feel uncomfortable. I suppose that it's just a phase and it will pass as we acquire more knowledge, or at least more practice in front of a patient. Don't worry, it's happened to all of us!!
Thank you for your column, it makes me feel that i'm not alone in all my doubts when it comes to know it all about medicine.
Take care
Posted by: adeLiniita | May 30, 2007 5:36:48 PM
Hey there Kendra,
Congratulations on beginning the clinical part of med school...actually this is where the fun begins..lol.I'm at the end of my 5th year(6 year MD degree)and we began our clinical training about 3 years ago. So that should add up to roughly 80-100 patients by now(including work during summer hols). I can safely assure you that it's perfectly normal to feel like you're faking it. I remember when i first started, the patients were asking me questions instead coz i forgot many of the questions i was supposed to ask and i had trouble keeping them from straying away from the topic of discussion.When it came to physical examination...i couldn't tell the difference between the heart murmurs..it always sounded normal to me. This really made me doubt myself and whether i was cut out for this. But 3 years later, i now feel like a real doctor..i know what i'm hearing through my stethoscope, i know what i'm supposed to be feeling for in the abdomen, and how all of it is connected to what my patient is telling me. So don't worry about it..it just takes time. Every patient you see brings you one step closer to becoming a 'real' doctor. Good luck to you! GBU.
Posted by: Melissa | Jun 2, 2007 9:16:31 AM
Hi, Kendra.I completely agree with what Yasmin said as with all other comments. But in my oppinion, you are not faking a real doctor.This part of your med school is,in fact, part of the process of "to be a doctor".I'm in the last year of medical school and i sure that, as all my classmates, at least several times,we have felt just like you, and i'm quite sure that this will not end upon our graduation. What we must do is to be honest and make patients feel like they're talking with a real doctor, as Yamin said. The difference between a bisferiens pulse and a pulsus alternans wouldn't make you a real or a better doctor. Just be patient and you'll became the real doctor naturally.
Best
Posted by: Dadson Sales | Jun 3, 2007 12:53:11 PM
Kendra-
I'm in nursing school and have stumbled across this website trying to fish for information regarding Law of Starling. I appreciate your humor and enjoy reading some of the comments. The encouragement you have generated by your readers have really helped me, for I have the same doubts about being a nurse. It's tough, cause I'm a single mom raising 3 boys (6, 12, 17yrs)and have many of the same doubts. Will I be a good nurse? Will I ever get it all figured out? Thanks to you and to all the reader out there for the humor and encouragement!
Posted by: Lisa M. | Jun 5, 2007 12:37:45 PM
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