Sunday, August 26, 2007

Time I'll never get back...

Wednesday I scrubbed in to the bilateral mastectomy (to clarify the woman's history, she did have radiographic lesions in both breasts, and she had three female relatives who had bilateral breast cancer in their 40s or 50s) and a lumpectomy. The surgeon I primarily work with on this rotation has something of a drill sergeant type attitude, which (thankfully) he does not use on the students (since we're not expected be competent), but increases in intensity toward each successive year of residency. Pretty much the entire case consists of his--not really "yelling", per se--loudly criticizing the resident's technique. Which I'm sure is fairly effective, but does leave the resident rather drained by the end of the case and me feeling pretty awkward having just seen my senior by six years treated like a three year old in front of a room full of nurses and techs. What fun I have to look forward to upon graduation! The next day I scrubbed into another mastectomy with a third year resident--there was still a lot of criticism, but only at about 50% of the intensity compared to the day before with a fifth year.

Friday had one theme throughout the day: inefficiency, purposelessness, and wasting time (I guess that's three themes, but they're all pretty synonymous). Normally, as I have joyfully described in the past, on Fridays I go in for an hour to the pathology lab then have the rest of the day off. However, the nurse practitioner told me the day before that there would be an interesting patient with a good exam at 11:00. So, after pathology I went to clinic. It turned out to be a different patient, but I saw her anyway. When I went into the room she had barely started filling out the five page form all new patients fill out, so rather than come back, I just went through it with her. Which was a mistake, because she kept going off on tangents--twenty minutes later I was getting nervous as this was the nurse practitioner's last patient of the day and I'm sure she wanted to go home. I managed to get all the information and in the interest of time decided to wait on the exam for the NP so we wouldn't be delayed by doing it twice. I got the NP and came back into the room--and was told by the patient she'd rather I not be in the room. Now, I completely understand this, and am actually surprised that so few women mind having a male student doing the exam (she was the first patient the entire month who asked that I not be in the room), but could she not have told me this 45 minutes earlier when I went in to talk with her? So, I waited in the workroom for the NP so we could discuss her case...and didn't leave until 1:30. Basically, three hours in which I learned absolutely nothing and could have been home, or studying, or working out, or etc.

But it gets better. I went to the mall that afternoon to buy a book from Barnes and Noble, and was accosted mid-mall by a man doing a taste test for flavored water. Being the nice guy that I am, I agreed to give him my time and answered his many questions: yes I drink soda, no I don't drink energy drinks, etc, etc, no, I would not buy flavored water based off the advertisement that it "has vitamins and minerals" (I was hoping he would ask me to explain why I wouldn't as I had a great 5 minute response on playing on people's gullibility ready, but he didn't ask). Then he asked for my address which I told him I wasn't comfortable giving, and forestalled his next question by telling him I wouldn't be handing my phone number out either. He wasn't sure how to handle it, and went off to find his boss, and I was then told that I wouldn't be able to participate (yes, I was crushed). Ten more minutes of the day wasted.

Lastly, I have to make a page for my school yearbook. After an hour on the computer last week during which time my computer, Damocles-like, was inches away from being thrown forcefully through the window into the busy street below, I decided that I will simply be giving the publishing company my photos on a disk and letting them arrange them as they see fit. However, I have to have hard copies of my portrait to give to my school. I put them on a disk and took them to the local drug store which I had heard had an uploader machine on which one could edit and crop digital photos. After twenty minutes of frustration in which the uploader machine decided that it could only read the photos I wasn't interested in, the several employees who tried to help me decided that I either needed to make a new disk or use their website. So, I went home, and went on the website, and three minutes later had my portrait cropped and ready to be printed. Grrr.

Saturday morning I went to the free clinic. I saw two patients with the typical hypertension/diabetes/hypercholesterolemia picture. I was able to manage their issues on my own, so the doctor just signed off on my notes and prescriptions without seeing the patients (one of my favorite things about the free clinic is that as a fourth year I get to play doctor). The other patient was a 21 year old guy with a small abscess on the back of his neck. I was getting excited about the chance of incising and draining it, but then the manager told me that we didn't have the equipment so would have to refer him to a general surgeon who sees uninsured patients. Oh well.


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