A Whole New World

I think the first thing one needs to admit when you're in med school is that us 1st year kiddies are kinda dumb. Yeah, yeah all you type-A's out there. This is how you got in the first place right, from our nerdy brilliance. But once you’re here, it’s incompetence city.

Case in point – clinical skills. For those of you who don’t know what this means, in first year we have ‘clinical methods,’ which basically teaches us how to do physical exams. Except half the time we don’t know what we’re doing. And that right now what’s supposed to be normal could just as easily be abnormal. 90% of the time, this is how the sessions go down:

Doctor-facilitator
“Okay so today we’re going to practice taking blood pressures…you there…you’re first”
Me to self
Okay [takes deep breath] ... I can do this…I’ve watched ER…
[Trying to look confident while struggling to put cuff on patient and stethoscope on arm]
Doctor-facilitator
"So do you hear the korotkoff sounds?"
Me
[Confused look on face…the wha sounds?]
"Uh, no…actually I hear nothing"
Doctor

[looking clearly confused]
"What? Are you sure? How is that possible?...

[Looks at my stethoscope]
… uh yeah you’ve got it turned the wrong way."
Me
Oops…

Worse yet, don’t pretend to hear or feel something if you don’t. It won’t end well. Your facilitator will know, and you’ll just end up looking like a complete ass.

Doctor-facilitator
“So you there med student, listen to this patient’s chest”
Me to self
Oh no, he’s talking to me…okay, calm down…listen to the patient’s chest
[Puts on stethoscope…do I even have this on right? Procedes to ‘auscultate’ chest]
I hear nothing…oh god, this patient has no heart beat! Oh my god, he’s dead!!
[starting to panic]
Doctor-facilitator
“So do you hear that…?”
Me
“Um….[looking around at others in groups desperately for help]… yes, yes I do… "
Doctor
“What does it sound like?”
Me
Oh crap…make something up…
“Yes…I heard S1, S2" (normal heart beat sounds – basically lub-dup)
Doctor
“Yeah…well…[trying not to laugh or sigh out of frustration in my ineptitude]…no…try again…"
Me
[Laughs nervously] Okay…try again… “Um, breath sounds?
Doctor
[Sighs to self]…”uh, no…clearly this patient has a pansystolic mitral valve murmur”
Me to self
Kill me now…

So there you have it. Be comfortable with feeling like you know nothing. It’s going to last for a while…