Friday, March 6, 2009

Finally, Doctor on the Rise!

Nope, not a physician yet. I still have two years (plus a few months) before I can throw the D.O. behind my name and start to actually be considered a doctor. However, this semester has definitely made me feel better about the path chosen.......that there might actually be a light at the end of the tunnel, one that leads me out of the classroom and library and into the hospital.  

The first great experience this semester was the autopsy. We did not get to actually perform one, as most of them are government/county positions, but we did get to watch four or five performed.  It's not pretty. In fact, it's actually pretty gruesome. I have colleagues who claim to have the most steel-lined of stomachs who had to take a few moments and head outside. It could be the smell, it could be the way the bodies are cut up to find the pathology behind the death, or it could be that they had loved ones who had to go through the same thing. All valid reasons to be a little queasy. For me though, it just made things seem all the more real. You hear about all the ways that people can be killed, or kill themselves, but when it's posted on CNN or heard on the radio it seems very removed.  We saw deaths from motor vehicle accidents, drug/alcohol overdose, suicide, and many more. Please careful, be doesn't make you lame.

The next experience was the trigger point lab.  A trigger point is a hyper-irritable place on the body, related to the musculoskeletal system, that usually manifests as a palpable nodule made up of taut muscle fibers. A trigger point injection is usually a combination of an anesthetic and steroid that lasts in the body for about 3 months or so.  Now I have a lot of experience giving shots when I was a medical assistant, but this is slightly different. You have to give about 4 or 5 injections, all around this trigger point, without taking the needle back out of the body. So the key is to take it out of the muscle, but still leave it in the skin.  This was no big deal with the huge lumbar back muscles, but when you have to do it into the muscle or ligaments around an ankle or elbow joint things get a little more tricky. However, musculoskeletal pain is so prominent that this will be a great tool to have in the 'ole doctor arsenal. 

The most recent experience was getting to draw some blood from my fellow classmate. Phlebotomy is something that I, and I am sure most people, take for granted. Nobody likes giving blood, but when you go to the doctor to do so, you never really think about what is involved. Most of the lab technicians, medical assistants, or physicians are quite good at it, but most people have had that one experience where they cannot find a vein and you get stuck multiple times. I was able to get it on the first stick on my partner, but he had some very prominent veins to use. It is going to be a scary experience that first time I have to do it on a hospital patient who is extreme pain or discomfort or a someone whose veins are hard to find.

The best experience of all though is when we go to IGC. It stands for something silly, but basically it is when we go shadow a doctor once a week. Depending on who your doctor is, you might get to do most of the patient exams. And my doctor is the shit. He basically hands me a chart and I get to do everything from the exam, to the diagnosis, and even start writing the prescriptions. Sure he checks my work and makes any changes he needs to, but when those patients leave the office, they tend to thank me as much as the doctor himself. That feels good.

So starting in July, I get to start rotations. This will be a month or two in each of many specialties in medicine including: Internal, Pediatrics, Family Med, ER, Surgery, Psych, Rural med, OB/GYN, etc.  I might even get to work at a prison for a month or so. This is when the real education will start.  I will keep yall updated about stuff, like delivering my first baby. Well, not MY baby.......oh you get it.

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