Part of the requirements for first-year medical students at my school is a weekly clerkship, where you interview patients under the supervision of a health care provider (usually a physician, but sometimes an NP, nutritionist, etc — mine was a social worker). Today was the last day of fall clerkship and hence the last day until February where I get to go to the hospital, sit down with a patient, and just chat.
I met lots of different people during my clerkship — mostly older adults who needed some sort of post-hospital care, such as home attendants, hospice, etc. I certainly feel a lot more comfortable interviewing now than I did in August, but at the same time I’m very aware that clerkship is unique and not much like the Real Practice of Medicine. For instance, today I spoke with a patient for almost an hour. That kind of thing doesn’t happen in clinic.
There was one thing, though. Some time ago, I spoke with a woman who had been diagnosed with a particularly aggressive cancer, hence the SW referral. As I asked her about family, she seemed kind of vague and forgetful of her kids’ names, etc. Jerking her head around, not really tracking, very edgy. I mentioned this to the SW and the resident following her case. Today, the SW told me that the doctors had said she was fine (that’s relative, I guess), sent her home, and a few days later her daughter-in-law brought her back in, saying she had been forgetting to take her meds. Several tests later, they decided that cancer traveled up to her brain.
As I was sitting there stunned and depressed and remembering my grandfather’s struggle with cancer that ended up in his brain, the SW congratulated me on my “insight.” Huh?
I guess finding something the teachers missed is every student’s dream, but my inclinations that way always leaned more towards “Discovering that some basic mathematical theorem is wrong and watching the entire structure of mathematics come crashing down.” (What can I say, I hate math.)
When the “thing” that people missed involves life/death/pain, congratulations are just not in order. I’m glad they caught it and all, but I can’t help feeling depressed on behalf of the family, and on behalf of my childhood self.