I’m So Lucky I Get To Be a Nerd

The firstyear medical students are here! Today was the first day of the Interviewing and Communications Skills course that I co-teach. Last year, I wrote about how amazing this course is: Amazing that it exists (I never had a course like this) and amazing how practical it is (I found myself utilizing the techniques in my own clinic).

Our job is to review that week’s teaching materials with the students, locate appropriate patients for practice interviews from the wards, observe the interviews, read the writeups, and provide constructive criticism.

And man, our job is fun. I’ve missed running around the inpatient wards. Well, sort of. I don’t miss the late evenings and weekends spent rounding, especially as inpatient medicine continued diverging into its own complicated specialty, and keeping current felt like a Sisyphean task…

This setup is perfect. We seek to interview only patients who are awake, alert, and not in pain. Most are thrilled to consent to a twenty-minute interview. They’re bored or anxious, and hungry for some light, pleasant interaction, a welcome distraction from their surroundings.

Because I am not part of the patient’s care team, I cannot access their charts, so the patient’s history is only revealed through their responses to the student’s questions. Often, one has to ‘read between the lines’ to understand the underlying medical  pathology. Patients don’t always know, or they have their own explanatory model. It’s a mental exercise to interpret the actual hospital course without the ‘cheat sheet’ of the chart, the labs, the imaging…

Today we had lovely patients, all with fascinating stories. We saw and heard about conditions and treatments that I have not seen or heard about since my own training. Fournier’s gangrene (a can’t miss diagnosis!). Saddle pulmonary embolus (and they survived!). Enterocutaneous fistula (will it ever close?). I even went back to my desk and read up on some of these diagnoses, at the expense of doing other paperwork.

I’m in a wonderfully appropriate profession for nerds.