rainy day reflections

Another Saturday rolls around and it's raining again. There is something reassuring and soothing about rainy Saturdays, maybe because I don't feel as bad about missing out on fun weekend activities due to the mounds of studying to be done. Studying or no, I would rather be comfortably at home in pj's on days like today.

The past week has been chocked full of learning, as per usual. As another week comes to a close I am left in shock once again at how quickly second year is flying by. The final exam for our first course arrives in just over a week. Wow.

While classes and small group were essentially a flashing freight train moving at the speed of light, two highlights stand out in the midst of all the craziness: pediatrics shadowing at the Pediatric Ambulatory Center housed at the School of Nursing and my physical exam teaching session.

Monday I donned the short white coat and draped my neck with my plum-colored stethoscope to attend the official physical examination teaching session with a trained "teaching associate." Until medical school, I had no idea this cadre of paid medical education personnel existed. Last year we were introduced to the paid teaching associates in the context of standardized patients. We students were tested in our patient interviewing skills with these actors given standardized chief complaints and patient histories. Our job was to extricate the clinical pearls that would hypothetically lead us to treat the patient appropriately. These actors quickly morphed into real patients as they played out the histories. The key to succeeding in these encounters was to treat it like it was real because they sure did. Two of my three encounters last year were darling patients, but one was a real piece of work. She clearly had a little too much fun playing the "difficult" patient because by the end I actually wanted to strangle her. LOL. Fortunately, the timer went off and her life was spared.

Back to the current experience...the paid actors this time were there to guide in the art and science of the head to toe physical. Initially, I felt mildly uncomfortable because the interaction seemed so skewed in its power dynamic. I could not stop myself from wondering what this person's background was, how he ended up on this particular career path. Do not get me wrong: he was amazing and knowledgeable and extremely relevant in his instruction. At the same time, my heart ached at the thought of a loved one of mine performing the job...particularly during uncomfortable maneuvers like the liver and thyroid palpations. Every time I did something that inside made me cringe a little, I couldn't stop myself from asking (perhaps to his embarrassment) "Are you okay? I'm sorry if that hurt..." His reaction seemed surprised when I expressed that, and I almost felt bad for having said anything. It just felt...right?

Outside of the above, I found the experience incredibly rewarding. We were really able to focus on elements of the exam that I had not practiced before, and that I was actually able to put into practice just two short days later when I was in the Peds Clinic. I was palpating submandibular, submental, suboccipital, supraclavicular lymph nodes (to name a few...there are sooo many), visualizing ear drums, checking reflexes, listening to heart and lung sounds, and palpating abdomens like there was no tomorrow! Surprisingly, the children were all great sports and allowed "Dr. Qadira" (as I was hilariously introduced by the doctor I was shadowing) to check them out! It is amazing how varied the clinical cases are even in the context of a primary peds clinic (where all the kids were scheduled primarily for Flumist vaccines). Goes to show there is almost *always* something going on of concern to parents and perhaps even of medical significance amongst the kiddie population. The time flew by and I left kind of high from the excitement of the four hours.

I am very excited for the clinical component of second year because I am definitely a hands-on learner.

Back to the books, I go, while the rain is still falling.