Wednesday, June 30, 2010

How the Dementia Patient Out-smarted Me

Every once in a while you have to let go of your pride and admit that someone has gotten the better of you. Whether it be sports, politics or even the world of medicine, the time is sure to come. It just sucks when the person who gets the better of you has dementia. 

One of my patients in clinic today appeared rather confused so I decided to perform a mental status exam on her...

Medical Student: Okay, can you spell world backwards?
Patient: No.
Medical Student: You don't want to try?
Patient: Why would I do that?
Medical Student: Okay. um, I'd like you to take this pen and draw a picture of a clock face showing ten past eleven.
Patient: Fine. (starts drawing) There. (shows me picture of a circle with 11:10 written inside of it)
Medical Student: What's that?
Patient: It's a digital clock. 
Medical Student: You win. I don't care if you think the president is Woodrow Wilson. 

Wednesday, June 9, 2010

Learn from the best

As I go through medical school I like to see what I want to incorporate into the way I practice medicine by watching those who have gone before me. For instance, humor:

Attending: Well, you haven't been taking your medication, you aren't changing your diet, you aren't exercising and you aren't losing weight. Your kidney function is failing. It looks like you are going to have to start dialysis if you can't get with the picture.
Patient: What? Oh no! I don't want to do that. My children would just die!
Attending: No, you would be the one who dies. (chuckles)
Patient: ("I don't find that funny" stare)
Attending: (continues to chuckle)

I'm learning so much!

Tuesday, June 8, 2010

Moving On

Family Medicine. The "who the hell knows what is coming in next" specialty (second to emergency I suppose). My first day on family went a little something like this:

Medical Student: Hello 75-year-old lady! Lets talk about what kind of exercises you have been doing since we saw you last.
Patient: Huh? Are you kidding? The only exercise I want to do is at night in the bedroom.
Medical Student: I wish you didn't look like my grandma

Hour later...

Medical Student: Hello super stressed out angry guy! What brings you into the office today?
Patient: My wife is bipolar, has scleroderma and addicted to oxycontin.
Medical Student: (practicing his empathy) I'm so sorry to hear that. That must be really stressful for you.
Patient: Look at these pictures I took of her on my phone of her passed out on the floor.
Medical Student: I wish you hadn't shown me that.

Oh what joys will come next!?!