#5
These past two weeks we've had to learn the breast exam. I'd say this is the first block we've started to encounter awkward clinical situations like taking a sexual history, saying the word orgasm in a patient interview, conducting clinical exam of the breasts. sidenote - I dare you to say orgasm ten times fast without laughing. Anyways, thought this might deserve a running diary.
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10:00 AM: I should probably learn how to do a breast exam before I have to do it on the standardized patient.
10:01 AM: Just googled breast exam.
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| lawnmowing |
10:01 AM: Just googled breast exam.
10:02 AM: Regoogled clinical breast exam.
10:10 AM: Watched a breast exam on youtube. That was awkward. Is that appropriate for youtube?
Should it be awkward? Should it feel normal? No, I'm pretty sure it should feel awkward. Why is anything related to sex so uncomfortable to talk about? Think about it, when's the last time you talked about sex with anyone? Even with people you have sex with?
Should it be awkward? Should it feel normal? No, I'm pretty sure it should feel awkward. Why is anything related to sex so uncomfortable to talk about? Think about it, when's the last time you talked about sex with anyone? Even with people you have sex with?
1:30 PM: Staring at pictures of placenta. I hate the placenta. I wish I knew what a chorion was. Every day I study embryo I move farther from a potential career in the NICU.
3:15 PM: Pelvic exam training at the simulation center. Shove fingers into rubber vagina. This seems brutal. I can't imagine doing this on an actual woman. "Howdy ma'am, let me just cram my gloved fingers up your vagina."
4:40 PM: Dean's reception. Tons of free food. Tons of med students flocking there. Best food - chicken fingers and artichoke dip. Observing some flirting going on. sidenote - I wonder how many intermedschool couples we'll have?
4:55 PM: Only rumors I've heard about the breast exam. Not as long as scheduled. Not that bad.
5:10 PM: Arrive for breast exam. Hope I get a dude.
5:15 PM: Everyone is super chatty before we split up to go to the exam rooms. Overcompensating for being nervous?
5:25 PM: Break into individual groups and walk over to rooms.
5:26 PM: Our preceptor is sick and not happy about it. She does not want to be there. Our standardized patient is in good spirits though, and she's joking around with us. Apparently, she's the infamous standardized patient who was told her breasts are "not remarkable" by a student last year. Not pleased.
5:30 PM: After the preceptor runs us through the breast exam she asks who's going first. Greeted with silence.
5:32 PM: First student goes. To no one's surprise, it's a woman. Guys are too nervous.
5:43 PM: Guess I'll go next.. Ken: I'm just going to inspect your breasts.
Patient: Don't use the word inspect, it sounds too sharp.
Ken: Yeah sure, sorry about that.
5:45 PM: Ken to patient: Can I ask you to move your gown so I can inspect your breasts?
Ken to self: every damn time..
5:47 PM: [touches breast] That wasn't so bad. Pretty much like touching any other tissue. Talking about breasts is by far the most awkward part.
5:53 PM: Next student goes. He'd actually seen this standardized patient last week in small group when we took sexual histories, which lead to this conversation:
Patient: Oh I remember you you're the student who helped me with my sex problems.
Student: Oh right, hope you're orgasming well.
Patient: Yep, it was fixed in a week. Thanks for your help.
Student: I do what I can.
Doctor patient relationship, violated.
6:07 PM: Student: So what words should we not use?
Patient: When you're observing the breasts, don't say "sag" or "droop." Especially with older women. "Feel" is also awkward. Just use examine.
Talking about breasts is awkward. I feel like there's a half-baked idea here. We should be trained in talking better. Especially good for introverts.
6:18 PM: Guys in peanut gallery whispering inappropriate breast jokes. Woman student not laughing.
6:32 PM: Last guy finishes up his exam: "Ok, I'm going to go over and tell your doctor that nothing looks remarkable here."
6:40 PM: Leaving. Not as bad as everyone thought.
3:15 PM: Pelvic exam training at the simulation center. Shove fingers into rubber vagina. This seems brutal. I can't imagine doing this on an actual woman. "Howdy ma'am, let me just cram my gloved fingers up your vagina."
4:40 PM: Dean's reception. Tons of free food. Tons of med students flocking there. Best food - chicken fingers and artichoke dip. Observing some flirting going on. sidenote - I wonder how many intermedschool couples we'll have?
4:55 PM: Only rumors I've heard about the breast exam. Not as long as scheduled. Not that bad.
5:10 PM: Arrive for breast exam. Hope I get a dude.
5:15 PM: Everyone is super chatty before we split up to go to the exam rooms. Overcompensating for being nervous?
 |
| shoutout |
5:25 PM: Break into individual groups and walk over to rooms.
5:26 PM: Our preceptor is sick and not happy about it. She does not want to be there. Our standardized patient is in good spirits though, and she's joking around with us. Apparently, she's the infamous standardized patient who was told her breasts are "not remarkable" by a student last year. Not pleased.
5:30 PM: After the preceptor runs us through the breast exam she asks who's going first. Greeted with silence.
5:32 PM: First student goes. To no one's surprise, it's a woman. Guys are too nervous.
5:43 PM: Guess I'll go next.. Ken: I'm just going to inspect your breasts.
Patient: Don't use the word inspect, it sounds too sharp.
Ken: Yeah sure, sorry about that.
 |
| sharp |
5:45 PM: Ken to patient: Can I ask you to move your gown so I can inspect your breasts?
Ken to self: every damn time..
5:47 PM: [touches breast] That wasn't so bad. Pretty much like touching any other tissue. Talking about breasts is by far the most awkward part.
5:53 PM: Next student goes. He'd actually seen this standardized patient last week in small group when we took sexual histories, which lead to this conversation:
Patient: Oh I remember you you're the student who helped me with my sex problems.
Student: Oh right, hope you're orgasming well.
Patient: Yep, it was fixed in a week. Thanks for your help.
Student: I do what I can.
Doctor patient relationship, violated.
6:07 PM: Student: So what words should we not use?
Patient: When you're observing the breasts, don't say "sag" or "droop." Especially with older women. "Feel" is also awkward. Just use examine.
 |
| must have been epic |
6:18 PM: Guys in peanut gallery whispering inappropriate breast jokes. Woman student not laughing.
6:32 PM: Last guy finishes up his exam: "Ok, I'm going to go over and tell your doctor that nothing looks remarkable here."
6:40 PM: Leaving. Not as bad as everyone thought.
See you on the other side,
from ken
taking requests for future blog posts. please comment or email.
Best running diary yet.
ReplyDeleteThanks. Anything related to breasts usually goes over well.
DeleteWe were doing some 12-leads this week in my recruit academy. We watched a video that showed an...interesting application method on an older, overweight woman. (The video definitely missed out on the finer points of using the back of your hand and avoiding cupping. It was seriously like watching someone drive stick shift. Terrible job. But hilarious?) The terms my TO used to describe it were "vigorous and aggressive." The guys in my class started giggling like little girls during the clip. Our TO cracked down on it. "Stop being weird. It's only weird if you act weird. This is what you do - this is your office. Own it. Stop being weird."
ReplyDeleteSound advice.
The words.. it's all about the words.
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