As I look in the mirror of the hospital locker room, the figure adorned in a white coat, stethoscope, and more IDs than boy scout has badges stares back at me. Pens and granola bars are shoved in every possible pocket, bulging in all directions. I feel like a child trying on my mother's high heels and dress; it is almost comical how much growing there is left to do before these will fit properly both inside and out. After getting lost in the dimly lit labyrinths of the hospital basement for 10 minutes, I finally find my way to emergency room and spot the top of my attending's head above a pile of charts. Hurriedly I rush towards him and he says "Neurology consultation, room 7. Go!" and hands me a chart. All that is written is "40 year old female with headache, blurred vision, and difficulty speaking. Please assess". A fellow medical student and I approach the ER waiting room and call her name, beckoning her to follow us. Just like real doctors.
The conversation begins as always: "What brings you here today?". As the story unfolds, I jot down everything that could potentially be relevant to the diagnosis. Facial pain, ear pain, no nausea/vomiting, so on and so forth. Thoughts and questions to ask appear like birds flocking to a pile of breadcrumbs; uncoordinated and chaotic. Did I forget anything? What else am I missing? We complete the neurological exam to the best of our abilities. Neither of us could elicit reflexes in the left knee or ankles. Is that just us? Or is there actually a problem there? But how does that relate to headaches? Think brain, think. We finish our examination and run back to find our attending.
He carefully sits down and reads through our chart; I'm happy to see we made less mistakes than yesterday on our first day. "Did you ask about a history of migraines?" Crap. I knew I forgot something. "What was her blood pressure? Always important to note the blood pressure when someone comes in with headaches". Where in their chart did it say her blood pressure? I can't remember. I jotted down a few more things to on my already exhaustive list of "things to read and study tonight".
We are babies taking our first steps into the medical world; surrounded by padded mats and watchful doctor parents excited to see our progression. Knowing all of this exists doesn't make it feel any less scary. Falling is just as scary when you can't fully see that the padding is there to catch you. Almost overnight I've gone from sitting in lectures learning about the different anatomical structures to looking in eyes and ears and suggesting tests. It's exhilarating and exhausting to be the newbie thrown into a sea of experts. But the good news is you learn how to steer that ship pretty damn fast and, most importantly, you learn to watch out for icebergs.
The conversation begins as always: "What brings you here today?". As the story unfolds, I jot down everything that could potentially be relevant to the diagnosis. Facial pain, ear pain, no nausea/vomiting, so on and so forth. Thoughts and questions to ask appear like birds flocking to a pile of breadcrumbs; uncoordinated and chaotic. Did I forget anything? What else am I missing? We complete the neurological exam to the best of our abilities. Neither of us could elicit reflexes in the left knee or ankles. Is that just us? Or is there actually a problem there? But how does that relate to headaches? Think brain, think. We finish our examination and run back to find our attending.
He carefully sits down and reads through our chart; I'm happy to see we made less mistakes than yesterday on our first day. "Did you ask about a history of migraines?" Crap. I knew I forgot something. "What was her blood pressure? Always important to note the blood pressure when someone comes in with headaches". Where in their chart did it say her blood pressure? I can't remember. I jotted down a few more things to on my already exhaustive list of "things to read and study tonight".
We are babies taking our first steps into the medical world; surrounded by padded mats and watchful doctor parents excited to see our progression. Knowing all of this exists doesn't make it feel any less scary. Falling is just as scary when you can't fully see that the padding is there to catch you. Almost overnight I've gone from sitting in lectures learning about the different anatomical structures to looking in eyes and ears and suggesting tests. It's exhilarating and exhausting to be the newbie thrown into a sea of experts. But the good news is you learn how to steer that ship pretty damn fast and, most importantly, you learn to watch out for icebergs.
