Beginning my LCE

(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.