September 5, 2008

• Awwwk-waaard…

  Moving right along down the choose your own adventure posts, today’s question comes from Dare2BDifferent, who asks: “What’s the most awkward thing that’s ever happened to you involving your work?”

  Oh jeez, I almost dont even know where to start with this one. The very first time I had to perform a rectal exam and got farted on? The first time I had to perform a vaginal exam on a none-too-hygenic female? That time in family medicine where due to the young age of a mother i mistook her child for her sister?

  The truth is, medicine is a pretty awkward field. People are constantly coming to you with things that are embarassing, disgusting, pitiful, humorous, or some hodgepodge of all of the above. Nor is it just in a hospital setting either…people find out you are a doctor (or in my case, an almost-doctor) and suddenly feel it is perfectly alright to whip out that mole that has been bothering them, or tell you about that horrible diarrhea they have been having lately.

  And sometimes the awkwardness is a result of your own actions. There was about a two year period where I simply lost the ability to carry on a conversation that DIDNT involve medicine. And you would probably not be surprised to find out how little people want to talk about the sick, the elderly, the vomiting, the bleeding, and the whole gamut of med school experiences when they are not actually in the field seeing it firsthand. All of which would lead to awkward pauses in the conversation until I could resort to…so, how about them local sports team, eh? Or recent celebrity scandal-that wacky a-lister.

  So trying to narrow down the multitude of awkward experiences that I have gone through in just a day, let alone the last 4 years is a pretty tall order. Despite that, there IS one particular instance that stands out in my mind as being incredibly awkward and uncomfortable.

  In the beginning of my third year, my very first rotation and clinical experience in the trenches ever was internal medicine. Being fresh out of USMLE step 1 (shudder) and anxious to make an impression in whatever way I could, I made my senior resident aware of the fact that I could speak spanish relatively fluently. On the whole, this came in rather helpful, since rather than having to call and wait for a translator, I simply accompanied the resident to whatever patient she was interviewing and did the majority of the workup myself. It was a great way to both improve and accquire my medical spanish.

  On one particular call though, my ability was definitely overestimated somewhat as I accompanied my senior resident to see Mr M. Mr M was rather well known to the hospital as he had been in and out with liver problems, kidney problems, blood problems…you name it, he had probably had it. Unfortunately, on this particular occasion, Mr M.’s test results indicated that he had finally reached complete kidney failure…endgame, if you will.

  Oh yeah, and Mr M-spanish speaking only. So my senior resident pages me from studying to come talk to a patient with her. I arrive in the room and begin translating, only to realize about three sentences in that I am basically telling this man I met not one week ago that he is going to die. By the fourth sentence, I also realize that I lack the proper vocabulary to explain this to him in any kind of compassionate manner.

  So before digging myself in to any trouble I cant get out of, I pardon myself and explain to my resident that this particular bit of linguistic acrobatics is going to be beyond my ability, and we will need to call for a hospital translator. Which we do, but all the while Mr M is waiting patiently to find out the end of what I was in the midst of telling him about the significance of his current test results.

  The translator arrived and resumed from where we left off, and all the while I stand there in the corner with the resident, not speaking, just listening and watching as Mr M finally grasps what is going on. A silent observer, invisible to the resident who doesnt need me any longer, the translator who is telling the patient his options, and the patient himself who has long sinced cease to notice me amidst his own concerns.

  One of my earliest experiences in clinical medicine, and certainly one that has and will continue to remain with me-I certainly wont be able to avoid similar circumstances, but I have done everything I can since to ensure that if I am caught at a loss for words again, it wont be due to my own inability, and it wont be in midsentence to the patient. Hardly the most amusing awkward medical story, but certainly one of the most important ones.

  -Almost Dr J

  • 10:27 am
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