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Medical Humor: Is She Dilated?

The following is something going around on the Internet. Not sure if it really happened, but I’d like to think it did.

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Doctor: Go see this patient, she’s going into active labour. I want you to check if she’s dilated or not.
Med Student: Um, okay. I will go check.

Medical student sees patient, checks the patient’s eyes, then reports back.

Med Student: Um…I think they both look pretty dilated.
Doctor: …What do you mean…both?

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Resource for Pre-med Students

Mike, who is currently a fourth year medical student at UCLA has put together quite a resource for those who are interested in getting into medical school. Those of you who are at that stage might want to check it out.

Here’s the link: Medical School Insider

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Getting Along With Nurses

Update (7/28): A nurse read my post and sent me a comment. I have included it below. Also, as pointed out by Karen in the comments section, nurses can be “hims” as well. It wasn’t my intention to leave out all the wonderful male nurses. Initially I had written this post with “him/her” but it felt too awkward. And due to my grammatical issues, I couldn’t bring myself to use “they” when referring to single nurse.
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Last week, in my post titled Doctors & Nurses, K8 left this comment/question:

I’m about to start the journey of medical school. If you had to give advice to someone just starting, what would you say is the best way to appreciate and/or get along with the nursing staff?

 

I thought that was a great question. And if you glance back at that post, you’ll see that I said I’d answer her question in a separate post because I thought it was such a good question. Now, I still think it’s a good question, but I am struggling with coming up with a good answer — at least a good enough answer to justify writing a separate post for it.

As I look back on my 3rd year rotations, I’d say most (probably 98%+) of my interactions with nurses have ranged from neutral to very positive. I remember the first time I felt like I encountered a rather — gruff — nurse. She kind of just brushed me off. She was busy. It wasn’t like she was overtly mean to me. Another time I asked a nurse to do something and she mumbled about doing it later. I was like, ok… and my senior resident swooped in and let her know that we needed it done immediately. Needless to say she was not happy with him. But she did what he asked. In her defense, she was having a bad day before we talked to her. I had seen her on the verge of tears minutes earlier.

I guess I can only remember 2 sort-of-negative experiences. The rest of the time I have had nurses who at least answered me. Other– er, many times I have been roaming the halls of the hospital, completely lost, and a nurse is usually the one who asks me if I need help and points me in the right direction. Other times I have been staring at a stack of charts and a nurse chimes in asking which one I am looking for and she finds it for me.

On the other hand, I know that there are medical students who have had bad experiences with nurses. One classmate of mine recounted one instance that almost had her in tears. I’d like to think that this is more the exception, though.

But back to the question that I had intended to answer.

Do I have a secret to dealing or getting along with nurses? No. Everyone will do it differently based on their own personalities. And admittedly, there will be some personalities that may not mesh very well. Occasionally I watched as some of my classmates interacted with the nurses. Honestly, there were times I cringed. I felt like they were treating them like “the help.” Sure, it was a snapshot; maybe my classmate was having a bad day.

As for me, one thing I made a point of doing was to introduce myself by first name to a nurse during my first conversation with her. Usually this would be in the beginning of the conversation. The introduction usually got me their name too. And I tried to use her name each day when I saw her. Because when you follow an inpatient for even a few days, most likely you will have to talk to the patient’s nurse multiple times. I never cared if the nurse remembered my name or not. But I wanted her to know that I knew her name.

That’s pretty much it. That’s my answer. Because at the root of it, all they want is respect for the hard work they do.

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After posting this, I received a comment from @eyeseeyouarein, an ICU nurse:

Take good care of your patients, we’ll like you. Do that and treat us with respect, listen to us, and show common courtesy in your communications? We’ll love you. Get to know us, trust our judgement, and be our partner in care? We’ll cover your ass.

So there you have it… a perspective from the nursing side of things.

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Today’s Medical Lesson — Sausage Fingers

In my continuing quest to prepare for Step 2 CK in just over a week, I have been going over practice questions. Here’s something I reviewed today — a condition called Psoriatic Arthritis.

Here’s is a picture depicting classic symptoms of the disease:



Classic symptoms include:

  • morning stiffness
  • deformed joints
  • nail involvement
  • dactylitis
  • “pencil in cup” deformity on x-ray of hands

My favorite one is dactylitis — aka “sausage digit.” See the man’s left index finger? That’s the sausage digit — a diffusely swollen finger.

And that’s the lesson for today.

And I have really been wanting to share about what I learned last week (or was it the week before). It was about something called the “anal wink.” But I guess that will have to be for another day.

Hope ya’all are having a fantastic Thursday!

Update: And a thanks to Ryan who commented below to remind me to add the “pencil in cup” classical finding on x-ray!

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Visit msnbc.com for breaking news, world news, and news about the economy

Meet Miss South Carolina. She was just recently crowned and she is planning to compete in the Miss America pageant in January of next year. She is a fitting pageant winner for this generation. Before she won her crown she lost over 100 lbs over 3 years. Her secret? Diet and lifestyle changes. Hard work. No easy way out. No surgeries. Just a commitment to getting healthier.

Her pagenat platform is “Eating Healthy and Fighting Obesity.”

I’ll be rooting for her to go all the way.

For more on her story, you can check out the MSNBC article here.

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Outside Reading — 20 Biographies for Medical Students

I recently received an email from a visitor to this blog about a list of 20 biographies medical students may want to read. Of course, we have so much extra spare time, right?

But I looked through the list and there were definitely some books that I would love to be able to sit down and spend some time with.

Maybe you have some downtime and would like some books to peruse?

Take a look: 20 Essential Biographies for Medical Students.

If you’ve read any of the books in that list, I’d love to hear your thoughts about it in the comments section!

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Can We Really Understand Our Patients?

The following post originally appeared on Medscape’s The Differential on January 12, 2011.

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Knowing I had recently completed a rotation in OB/GYN, a friend asked me how they (medical schools) make male medical students understand what their pregnant patients feel like. It was an interesting question. And it got me thinking about understanding what our patients go through – no matter their age, or sex, or condition.

As medical students, there is not much discussion about how our patients feel. Sure, there are classes about human suffering. But these classes deal with generalities. Each patient experiences their condition in their own unique way. To draw upon the obstetrical cases, telling a woman that she is pregnant can be met with a variety of responses that range from fear and dread to joy and elation.

I once heard Dr. Wil Alexander say, “The moment a symptom occurs, a story begins.” Those words seemed so profound at the time that I wrote the idea down and saved it. Each patient who walks through the hospital doors is more than a symptom. They are more than a diagnosis. They are more than a disease. They are human beings who have a story – a story that is just waiting to be told.

The question that my friend raised, regarding how male medical students are made to understand the experiences of their pregnant patients, made me realize that there is little done to help us understand our patients’ experiences. But I am okay with that. Because each experience is too individual to explain away with a blanket statement. It is impossible for anyone to know exactly how another feels.

The important thing, in my opinion, is for us to connect with our patients and convey that we acknowledge that they are going through a difficult or trying situation and to offer ourselves as they cope with it. It can be something as simple as giving them permission to be candid about their raw emotions – the frustrations and fears that build up – in a safe environment where no one will betray their trust or judge them or treat them any differently because of it.

It would probably be a good thing if we could understand exactly what our patients were experiencing. It would probably help many of us with our empathy. But without that ability to understand perfectly the experiences of our patients, we are left with the ability to accept perfectly the experiences of our patients. And I suspect that for most of them, this much is enough.