Monday, November 16, 2009

Enthusiasm on the Job

"Everything's cool when you're a first-year medical student," said Dr. Katz as he accompanied me to visit the orthopedist 3 floors above the internal medicine office. Last week, Dr. Katz and I saw a patient who was having terrible pain in her foot because she had to step quickly to the side to avoid running into her dog. For real. Because he thought it would be an interesting learning experience for me, Dr. Katz suggested I go with her to the orthopedist (in the same building) to see them do the x-rays and casting (if necessary). Well, I went with the patient, but unfortunately, I had to leave for the day before she had even gotten an x-ray. Today I went to the office early so that Dr. Katz and I could go up and see the x-rays -- my first experience of continuity of care, I suppose. Indeed, the patient had broken her fifth metatarsal in a place that doesn't receive much blood flow, so she needed a leg cast that will be on for 4-6 weeks. The orthopedist and Dr. Katz were both eager to explain how those types of breaks normally happen, what the different types of treatments are for different types of foot fractures, etc. So now, according to them, I'm an expert on foot fractures.

Those two weren't the only eager doctors today, either. A few weeks ago, Dr. Weisholtz wanted me to feel a large thyroid. Today, just after Dr. Katz had observed me interview 2 different patients, Dr. Kocher came into the common area and asked, "Where's the medical student? I want to show her something." I waved and followed him into his patient's room. She had chronic lymphedema (swelling) in her left arm, which was easy to see when comparing the arms. But there was something else that Dr. Kocher was even more excited about. He asked the patient to show me her palms. Then he asked me, "What is different about her palms compared to mine? Or yours?" I looked at my own hands and then the patient's, and I could see that hers were quite yellow. I said as much to Dr. Kocher, and he said, "Yes, exactly. But look at her eyes. They're nice and white, so you know it's not jaundice. Want to know what it is? It's carotenemia!" The woman explained that she had been drinking carrot juice -- LOTS of carrot juice. All of the beta carotene had colored her skin yellow.

Yes, Dr. Katz is right -- everything's cool when you're a first-year medical student.

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