Crossing the line from a normal person to a doctor

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There are some things in medicine you’d think it’d be quite important to get right. To have good technique and know what you’re doing. For, you know, everyone’s sake.

Yeah, right.

Doctor: “So, what do you want to get out of this clinic today?”

Me [uncharacteristically prepared]: “Well I’d like to understand the basic management of some of the common urological presentations, like haematuria and prostate cancer. And I’ve never done a PR, so I’d like to learn how to do that if possible.”

Doctor: “Great! We’ll see what we can do.”

Half an hour later, in walks Mr Unsuspecting Prostate.

Doctor: “I’d like to examine your prostate if that’s alright”.

Mr P: “That’s fine, doctor”.

Doctor: “And we have a medical student here today. Do you mind if she examines your prostate as well?”

He sits back down at his desk, leaving me standing there with a glove, a sachet of lube and a patient in front of me in the foetal position. I think this is most awkward I’ve felt since coming to med school. I guess I thought there might be some…instruction. I’m aware that if I ask what to do it might make Mr P feel more uncomfortable. And yet if I don’t, I might as well be any old person off the street who just happened to find a glove, some KY jelly and an interesting opportunity.

Oh well, perhaps that line was crossed a while ago. Anyway, I should know. How hard can it be?

I sigh, choose a finger, and go for it.

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Fitting: https://dailypost.wordpress.com/2014/03/27/prompt-the-great-pretender/

 

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Decisions

The consultant looks up from his notes as Mr Mitchell walks in.

“How are you?”

“I’m fine! Just back from holiday.”

“Right. Well, I’ve been looking at your CT scan, and we’ve found a little… blob… on your kidney.”

“Oh, right”.

“Yes. Look, here’s your scan. This is you!”

“Oh. Yes, right”.

“See here? This is your right kidney. See the shape of it? And there’s the left one. Now. Can you see that extra bit at the bottom? They look different.”

Mr Mitchell seems nonplussed. “Ah.”

“That’s the blob I was talking about. I’m afraid it looks malignant”.

“Ah. What does that mean?”

“It looks like cancer.”

“Ah. Oh. Can you fix it?”

“Well, almost certainly yes. The tumour hasn’t spread anywhere else so we have a couple of options. We can go in and take it out, and leave half the kidney behind. But you can see the lump’s quite big so there’s a chance we might miss a bit and there’s also a risk of bleeding. Alternatively, we can remove the whole kidney. You can survive with one, you know.”

A lot of people think you get wheeled into a hospital ill and walk out better. But every day I see the opposite – people who walk in feeling fine and come out with more than they bargained for. I sit in the corner of the room and watch Mr Mitchell’s face, amazed as always at the trust people have in their surgeons. And at the momentous decisions they can make when put on the spot.

“Ah. Yes. I think removal is the thing.”