Pay no attention to that man behind the curtain

Observerships are funny things. You contact a physician in the field you're interested in. They write back. You set up a mutually convenient time, and essentially become his/her shadow for a couple hours. It's not very complicated, except for the fact that patients sometimes tell their doctors very personal stories. And the poor medical student trying so desperately to blend in with the upholstery is privy to it all.

Case in point: I was scheduled to do an observership with a pediatric specialist one afternoon. Due to a snowstorm, I got to his clinic a little late, and he was already about to see his patient and her mom in the examination room. He told me to drop my stuff off and go in with him. Feeling guilty (for my tardiness - how unprofessional!) and rushed, I threw my backpack and jacket in a corner, clipped my nametag on, grabbed my stethoscope, and ran to the room. The door was open, so I put on my best "I-have-no-idea-what-I'm-doing-I'm-not-a-doctor-but-trust-me-anyways" face and slipped in. The exam room was TINY. Like, the size of my closet at home. The patient, a little girl, was sitting on the examination table, swinging her legs happily. Her mother was sitting on a chair against the other wall, her knees practically touching the edge of the exam table. The doctor was sitting at a tiny desk that his long legs didn't even fit under, and the 3rd year clerk was standing behind the door. Literally. The first thing I saw of him was his head, peeking out from around the door. The room was THAT small. There was nowhere for me to inconspicuously stand except the middle of the room, or the corner farthest from the exit, between a chair and a counter. I crossed the room and squeezed myself into the corner, feeling about three feet too tall and a couple inches too wide.

The doctor started off by taking a focused history, made a few jokes, and then asked the mom if there was anything she wanted to ask before he did the physical.

Doctor
Was there anything else you wanted to talk about?

Mom
Um... Yes... yes, there was something else.

Doctor
[compassionately]
And what might that be?

Mom
She- she's been in going through some grief lately, and I don't know if that might affect her condition.

Doctor
Why, what happened?

Mom
[Bursting into tears]
My husband just died.

Doctor
[Leaning forward]
Oh my goodness, I am so sorry!
[Pats her on the knee twice, leans back]

Me to self
[Staring up at ceiling, humming tunelessly]
Pretending I'm not here...

Doctor
May I ask how it happened?

Mom
[sobbing]
He had a heart attack in August.

Doctor
[Nodding, oozing wordless sympathy]

Clerk
[Nodding in a credible impression of the doctor]

Me
[Pressing into the corner, hoping to be swallowed by the white white walls into sweet oblivion]

It was awkward. So very very awkward. As I was standing there in my ridiculously tight corner, the stethoscope I don't know how to use clutched in my hand, I was forcibly reminded of a quote from a clinical skills study guide:

" If the patient becomes teary... gently gaze at the patient with a compassionate expression in your eyes. It is permissible to convey supportiveness by resting your hand for one second gently on the patient's shoulder or upper arm (not the leg or hand, and do not pat)."

Ah yes. Like so many things in life, it's so simple in theory. It's the practice that's the problem.