Preceptorship

And since Aliens is one of my favorite movies, here's an image worthy of H.R. Geiger. The stained teeth come from administration of tetracycline, an antibiotic, in utero or early childhood, when teeth are developing. This is no longer done, but it brings me to the main point of today's blog: kids.

We have a class called Clinical Practice of Medicine, or CPM, where the basics of doctor-patient interaction are taught. It's one of the three courses given the first semester, combining lecture and practice of very basic medicine in a doctor's office, or preceptorship. We are assigned in pairs to various practices around Buffalo, and, alternating the weeks, we learn how to take a patient's history, how to present the patient to the doctor, and basic procedures. The variety of doctors is limited, usually family doctors, internists, and pediatricians. Because in the pre-assignment survey I let it slip that I have no difficulties with kids (for obvious reasons), I was assigned a pediatrician in a bad part of town. And it's been a wonderful experience so far. I worried that I wouldn't have an opportunity to see or learn much, being saddled with nothing but well-child visits, but it's been just the opposite. The variety of cases in an underserved area is just staggering. To resort to an old cliche, it's never the same day twice. Even routine well-child visits bring with them concerns, or problems that the doctor has to address.

Slice of Life Vignette

Continuing with Dr. Detroit's theme of obvious titles for the blogs, here's another one. To the left of the text is a cross section of a human body. Done at about heart level, this is a fairly standard learning tool in an anatomy class. As a matter of fact, we're to expect two of these guys during tomorrow's exam. Yup, tomorrow's the big exam: 40% of the grade is riding on it, and I can only study for a few more hours before my brain shuts down. A friend of mine vowed to stay up till 2 am. Others will be pulling overnighters. I'm too old for this, so maybe it'll be off to bed at 1 am, with a rousing to a freshly made coffee (whoever invented programmable coffeemakers needs a statue in the center of some European city) at 7 or so. Now, taking a little break, it occurred to me that once again I have the unique privilege to work and study things that 99% of people won't ever see or only in special settings like museums. These slices (click here for more) always remind me of the first time I've seen such things. It was in the Chicago Museum of Science, where longitudinal slices of human beings encased in glass were on display. It wasn't disturbing, but fascinating.

Another bit of trivia: McBurney's Point is the location used to locate the appendix. In the event of pain in the right lower quadrant of the abdomen, the doctor will press his finger at this location. Rebound pain--felt after the finger is released--will occur, and may indicate an inflamed appendix.

The last bit: when the doctor asks you to turn your head and cough when checking for hernia, he just doesn't want to breathe your gems. There is no diagnostic purpose to the turning of the head.