(journal entry from September 2, 2008)
Tomorrow I begin my Longitudinal Clinical Experience with a doctor in private practice at a clinic in west Phoenix. This particular doctor was high on my ranking list of possible preceptors, and I’m really glad that I was assigned to work with her. I put a great deal of thought into my ranking of the possible LCE clinicians, and I was drawn to this lady for a number of reasons. For one, her list of hobbies includes "ensuring quality sleep, finding balance between home vs. office, family vs. patients, me vs. the world," which by its own merit makes her shadow-worthy in my book. I hope to learn from her ways in which a physician can work to nurture both her personal life and her practice. She also works in a low-income neighborhood, which appeals to me since my professional interests are in the healthcare of underserved populations as well. Though she is currently in family practice, this doctor worked for several years in obstetrics/gynecology. My specialization interests are split between family practice and ob-gyn, so I hope to discuss with her the intricacies of both fields.
My biggest concern at this point is my knowledge (or lack thereof) of medical Spanish. Apparently Spanish is the primary language spoken by patients at this clinic. I love the language and can understand it with moderate alacrity, but explaining medical conditions in Spanish is another matter entirely! Basically, worst case scenario I envision myself trapped without an interpreter in an exam room trying to ascertain the 7 cardinal symptoms from a Spanish-speaking patient, tripping over my tongue and saying things like "you sit bad when you throw your cabbage" instead of "does it hurt when you turn your head?" I did some independent studying of the language over the summer, but as soon as school started with all of its concrete, tangible deadlines, the little bit of self-discipline I had was lost in a hurry. I anticipate that the learning curve will be pretty steep. In the long-run, I think this sort of forced immersion will be beneficial in helping me solidify language skills that I've been wanting to improve for quite some time now. There may just be some awkward encounters in the interim…
I am interested to see if there will be any socio-economic or racial barriers between me and the patients I interact with. I am part of a church that meets in a low-income area of South Phoenix, and I’ve been working with the teenagers in the church for several months now. They constantly highlight the racial and socio-economic barriers that separate them from me. (These are barriers that I have been laboring to break down. Yes, it is possible for a white person to have rhythm, and, far from being affluent, I am merely a student who gets hand-me-down clothes and whose net worth is currently around -$25,000.) I don't need to explain how these perceived divides create barriers to communication. My youth kids don't fully share their struggles with me because I "just wouldn't understand." I wonder if these sorts of barriers will translate to the clinic in West Phoenix, where I am again trying to gain the trust of people from a background different than my own. Will my patients will feel comfortable talking with me at ease, or will they withhold critical information because of a perceived divide? My experiences with the kids at my church lead me to believe that communication and friendship is possible; it just takes patience and time.
My hope is that through my longitudinal clinical experience I will be able to reinforce material covered in doctoring and other classes. I hope that I will be able to connect with my patients, hear their concerns, process what they tell me, infer what they do not tell me, and diagnose their ailments. I hope that I will receive guidance, patient critique, and encouragement from my attending physician. Above all, I hope that I will learn - how to speak, how to listen and how to understand.
Wednesday, December 10, 2008
Wednesday, December 3, 2008
Reflections on Clinical Anatomy
(journal entry from September 2nd, 2008)
Unnatural. The first word to cross my mind when we opened up the body bag on our first day of anatomy and saw the body of a woman cut from neck to naval was "unnatural." The aberrancy of the scene was worsened by the natural position of her body - she was lying off-center and had one knee slightly popped, with her hands resting palm-down at her sides. This was not the sterile picture of a cadaver that I had seen in text books. This was a woman who was dead and was lying with readily exposable organs in front of me.
Though the initial image was strikingly unnerving, after the initial shock wore off and we began to examine her internal organs I was more or less undisturbed. Before coming to lab on that first day I had tried to mentally prepare myself and put into perspective what I would be seeing and doing. On one hand, one could describe the ritual of anatomy lab as being grotesque. Students with little to no knowledge of the location of bodily organs try to gain an appreciation for said organs by burrowing elbow-deep in the innards of a complete stranger. One could also appreciate anatomy lab from a much more positive angle. In an indescribable act of altruism, 8 men and women donated their very bodies and thus gave all that they could in a profound, post-mortem way to further the education of 48 medical students who will one day improve the lives of the donors' children and their children's children. I had decided to take the latter of the two outlooks, and so as we reflected our donor's thoracic cage to expose the organs underneath, and as I picked up the towel laid across our donor’s head to peer at her face, I remembered and thanked God for her gift.
I’ve really enjoyed my time in the anatomy thus far. The internal structure of the body is something I’ve wanted to understand for years now. I love learning how things fit together to create a bigger picture, and I’ve always seen the body as a sort of a puzzle or black box; food goes in, life comes out. It is truly satisfying to unveil the mystery and see how intricately interwoven and meticulously designed our bodies are.
Unnatural. The first word to cross my mind when we opened up the body bag on our first day of anatomy and saw the body of a woman cut from neck to naval was "unnatural." The aberrancy of the scene was worsened by the natural position of her body - she was lying off-center and had one knee slightly popped, with her hands resting palm-down at her sides. This was not the sterile picture of a cadaver that I had seen in text books. This was a woman who was dead and was lying with readily exposable organs in front of me.
Though the initial image was strikingly unnerving, after the initial shock wore off and we began to examine her internal organs I was more or less undisturbed. Before coming to lab on that first day I had tried to mentally prepare myself and put into perspective what I would be seeing and doing. On one hand, one could describe the ritual of anatomy lab as being grotesque. Students with little to no knowledge of the location of bodily organs try to gain an appreciation for said organs by burrowing elbow-deep in the innards of a complete stranger. One could also appreciate anatomy lab from a much more positive angle. In an indescribable act of altruism, 8 men and women donated their very bodies and thus gave all that they could in a profound, post-mortem way to further the education of 48 medical students who will one day improve the lives of the donors' children and their children's children. I had decided to take the latter of the two outlooks, and so as we reflected our donor's thoracic cage to expose the organs underneath, and as I picked up the towel laid across our donor’s head to peer at her face, I remembered and thanked God for her gift.
I’ve really enjoyed my time in the anatomy thus far. The internal structure of the body is something I’ve wanted to understand for years now. I love learning how things fit together to create a bigger picture, and I’ve always seen the body as a sort of a puzzle or black box; food goes in, life comes out. It is truly satisfying to unveil the mystery and see how intricately interwoven and meticulously designed our bodies are.
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