A Day at the Clinic
by Jaison John, MSIII
When I found out that I was going to a general practice for my first hospital visit, I was kind of disappointed. Up until then, my experience with shadowing doctors in general practice had been very mundane. In the clinics where I'd shadowed in the past, all the patients came in for regular checkups or came in with hypertension and diabetes. It wasn't anything "interesting." I decided to go because I decided that it could be a great learning experience and even if I got bored, I would still get some hospital exposure.
On the day we got to the general practice on an SGU-provided bus. It was a tiny building that had a small sign with the main attending's name on it. We sat in the waiting room for about ten minutes before she came out to greet us. Then, she took us back to her office and told us we were to do history and a physical exams, as needed, on her patients. In my mind, I was freaking out! Even though I had done multiple patient scenarios in my classes, I wasn't comfortable with this. I wasn't ready for actual patients and real-world consequences. I thought we were just shadowing the doctor. I thought that we might get to talk to the patients if we were lucky. But our attending wanted us to be medical students. She wanted us to be doctors-in-training.
She split the seven of us into two groups and we went to see her patients. I was very reluctant but I didn't show that on the outside.
Our first patient was a 1-year-old child who came in with wheezing. One of my classmates started taking history from his mother. I wasn't ready yet. His mom said that there was a history of asthma in the family but that particular child had not been diagnosed with anything yet. One of us did a complete chest examination and told us she could hear some "strange noises" in the little boy's lungs. I immediately took a listen to the patient's chest. I had heard those sounds before. Were they wheezes or crackles? "Definitely wheezes," I thought to myself. But I didn't say anything to the others. Everybody got to listen. "What if I'm wrong? Let's just let the attending talk about it."
The attending came in and asked us what we were listening to in the chest. Everybody kept quiet. The attending said that it was wheezing.
"I knew that answer," I thought to myself. "If only I was confident to speak up, then I could have been the star pupil, at least for today."
Confidence was something I had been working on for the past few years. But this incident made me realize how helpful it could be. When I got back home, I started to work on my confidence so I could speak up when I knew an answer. I'm still working on it. However, I have learned that gaining knowledge and doing things outside of my comfort zone boosts my confidence. So now I have an idea as to how to work on it.
Our next patient was an elderly lady with some sort of an eye infection. I decided that this time, I would speak up. I started taking the history but was stuttering and all over the place. My colleagues helped me out with the history. When we presented the case to the attending, I realized that my history-taking skills were so abysmal that the attending was confused and had to ask the patient some questions directly. The attending was very nice about it, but I should have been better prepared.
Confidence is not enough, I needed to be prepared as well. On that day, I decided never to go to any hospital unprepared. Even if I didn't know what to expect, I would try to find out from upperclassmen or other sources, I would not be caught unprepared ever again.
I am so glad that I went on that hospital visit because it gave me a new perspective on general medicine and life in general. It gave me life lessons that I can take with me into my clinical years, my residency and even into my practicing years. It has made me a better medical student, and someday, a better doctor.