To The Left...To The Left

When I was little I took an intelligence test and I got an obvious question wrong: I did not know my right from my left. To handle this fault, I wore a ring on my right hand and I quickly learned just how to properly answer this question. I thought my right left issues were over until I was confronted with them head on during day two of physical exam practice. I had to learn to test the eyes and the ears.

Because my partner went first last time, I was doctor first this week. I started by examining the ears. Otoscope in my right hand...no problem...a bit ear wax-y and nasty, but I could see what I needed to see. Now onto the other side. Suddenly, I could not figure out how to hold the damn otoscope correctly. I moved my hand around, changing positions over and over, until my partner finally grabbed my hand, put it in the right direction, smiled and I went on my ear-viewing way. Next, after testing his hearing by whispering words with two similar syllables and seeing if he heard me (words like baseball and ninety-nine were suggested, though I wish we could say something funnier like blue-balls), I used the tuning fork to test how he could hear the vibrations in his ears. I hit the tuning fork and tested the differences in sounds from both ears without a problem problem. I hit and test it with my right hand to his left ear. Again, no problem. Yet, when I hit and test it with my left hand to his right ear, the sound stops. Every time I grab the tuning fork after hitting it on my other hand to start the vibrations, I stop the sound when I go to put it up to his ear. You would think I would figure out how to fix this amateur mistake after one try, but no, it took me four times. Our clinical preceptor looked at me and could do nothing but laugh. I replied, "wow, I am a bit bad with my left hand". To lighten the mood and to cover up my obvious awkwardness, as he is a pediatrician, I also added, "sorry, I am like teaching one of your patients to be a doctor".

After the ear debauchery I moved onto the eyes. Testing the visual fields, I realized it is oddly hard to make my left fingers move in odd global movements (as if the patient has a fish bowl on his head) at the same time as my right ones. I then grabbed the ophthalmoscope and tried to find the optic nerve and optic disc. Looking into eyes is incredibly challenging as you are up against not only your eye problems (near/far-sightedness), but also that of the patient. As you move closer to the eye, you have to adjust the light over and over to get clarity and you also have to get so close to the patient that you feel like you are going to make out with them. To help with this invasion of space, we do the exam right eye to right eye and left to left, but it still feels a little too close. In his eye I see some vessels, and what I think is the optic disc but I cannot be sure. It is so hard to see a picture in a text book and then actually see it correctly in the eye, especially when the preceptor cannot see what you are looking at. I spend forever just trying to get my view to be clear in his eye that I feel so bad when my partners mentions that he needs to blink and his eyes need to water so I move on to the other eye. Left to Left. I quickly figure out that I am so right eye dominant that with my right eye open I can't even get my left eye to look THROUGH the ophthalmoscope, let alone focus on the optic nerve. What... a shocker. I keep trying to force my left eye to look into the device and I even try backing up from the lens and trying to see through it from afar. No luck. I learned later on from my eye doctor sister-in-law that for a while I should probably cover my right eye with my hand or just close it, to be able to teach myself to use only my left. So logical, but yet, so hard to figure out in the moment.

The eyes and ears day over, I felt utterly incompetent. Left, Right, Left, Right, Left....it is nothing but ambidextrous practicing from now on. Stupid one handed-ness.