March 23, 2011

playing doctor

bam, bam, bam...

bam, bam, bam...

bam, bam, bam...

DING, DONG...

Huh?  Wazzat.  I groggily rub the sleep from my eyes and try to jump start the grey matter to process what that sound is.  It's the door.  Somebody's at the door.  It's morning and somebody's at the door.  My wife has already left for work.  You need to get up and get the door.  My son beats me to it.  It's my dad.  A splinter decided to stick his finger last night and this morning decided to makes its presence known by pulsating.  Not necessarily a good sign when you can feel your pulse in your finger, especially in someone whose immune system's might is on par with France.  He has with him some really nice tweezers.  Swiss made of high quality tempered steel.  Nice.  They fit comfortably into my hands, a familiarity bred by long hours spent together.  They should.  With these types of tweezers, I was once able to dissect the vasculature of mice.  I make quick work of the splinter.  Remembering my anatomy, I look for streaking up the sides of the fingers or any swelling in the hand.  None.  Good.  I clean it with soap and water, apply some iodine, and then slap a band-aid with a hefty side of neosporin on it.  It's reassuring to me that I can do basic things while half asleep.

Later that day, I play doctor again.  This time it's for a grade.  I need to extract a comprehensive medical history from a 'standardized patient' (SP) who's pretending to either have a headache, abdominal pain, or chest pain.  Mine has abdominal pain.  Like most of my exams of late, I pretty much wing it.  I figure with the amount of time I've spent around doctors of late that if I've not picked anything up along the way, I have no business becoming a doctor.  Other than forgetting two minor questions, it goes off without a hitch.  At the end, the SP is supposed to critique us and offer constructive criticism, especially on our bedside manner (my school is making an honest effort to train humane physicians).  He states, "I'm supposed to find something for you to improve upon, but honestly, I can't find anything.  You put me ease.  You listened.  You didn't have your face stuck in your notes."  Well, this ain't my first rodeo but it still feels good to hear it back.

When I get out of the exam session, there's a message on my cell phone from my sister-in-law.  She has a question about my brother.  He has developed these little bruises all over the back of his leg.  The word petechiae jumps right into my mind.  Not sure how or why.  I think the word stuck in my mind because it's fun to say.  Petechiae, most likely, I tell them with some level of confidence.  Essentially, they are little bitty bruises where the capillaries rupture and can be evidence of several different things.  Infection, vasculitis, or in his case, most likely indicative of a very low platelet count.  In the absence of any fever or bleeds, it's nothing to run to the ER about but it's also something that the doc needs to know in short order.

A hat trick of doctor-playing episodes later, it's striking to me that all of these came to me with little conscious effort.  I'm not sure I'm any better at dealing with the emotional struggle at hand (in some ways, I think I'm worse with practice), but when it comes to basic medical questions, it's becoming second nature to me.

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