Since there’s been a fair deal of talk lately about us silly, idealistic medical students, I thought I’d put my idealism to the test this weekend (well, actually I had already signed up in advance, but it’s a little more dramatic, right?).

Friday night. Four hour shift. Emergency Department. First thoughts: The ER ain’t ER . Maybe if I stayed longer, I would have felt all that sexual tension and interpersonal conflict amongst the nurses, doctors, techs, and clerks. Shadowed an intern for most of the evening–we saw a woman with crippling rheumatoid arthritis, a student with some abdominal pain, a woman with vaginal bleeding, and a man whose pulled tooth socket wouldn’t quit gushing. You could kind of tell he was new at this, if you squinted a bit. He forgot to ask a couple routine questions, wasn’t too familiar with how to prepare for a pelvic exam, and received a bunch of corrections from the attending. Not that I’m saying I’d do any better–just noticing. One thing that was encouraging about starting to learn clinical and patient skills this early is that we’re still completely fresh and blank slates for our clinical knowledge. One of the patients was an elderly Hispanic woman who spoke no English; instead her daughter translated for the doctor. The intern kept addressing the daughter instead of the patient, which is a totally natural reaction, but when working with a translator, it’s generally thought to be better to address the patient. A third-year resident did something similar, so I don’t know if the skill was never taught or each of the physicians were too tired to fully think. The earlier we get this stuff, the more time we have to practice it and get it right. The nurses pretty much ran the place–I think the whole department (if not hospital) would come crashing down without their foresight and leadership. Another question–when the hell is voice-recognition going to catch up to the rest of technological advancement? I began to think that “ER” was just short for papERwork; we spent at least half the time documenting patients. Transcriptionists are expensive, and I’m sure medical lingo will be a tough hump to get over, but the sheer amount of time spent on paperwork was astronomical.

Saturday morning: the clinic. An elderly Vietnamese woman I was screening was laying on the flirtation pretty strong. I looked like “an angel” and “an actor,” and she was wondering if she could paint me. After I politely declined, she asked me if I wanted to have lunch with her–she had a nice Vietnamese girl that I should meet. I declined again, and noticed that she’s scheduled to come back next week for a full visit. Can’t wait.

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