My first foray into learning about the female came from my "how to do a breast exam session". I did my homework before and was completely ready for the session, and, frankly, it was one of the best learning sessions I have had in medical school, but can I just say how weird it is that people SIGN UP to be models/patients for these things? At my school, these patients are called Gynecological Teaching Associate's or GTAs and they are like specialized standardized patients who are trained to actually instruct us while also acting the part. You know, they can tell you things like "you are in the wrong place" or "you are pushing too hard" or "you aren't saying the right things". It is cool, in a way, that they know what is right and wrong and are actually physically sure that you are wrong, but it also is insanely awkward to have someone comment every step along the way of what you are doing. For breasts, its not a huge deal that the person you are touching (in what any other world would be completely inappropriately) is instructing you at the same time, but do not EVEN get me started on the GYN exam. I am all for feminism and women's health, and truthfully I would not learn without them and for that I am extremely grateful, but I have a feeling that those people might be seriously disturbed.
Anyway, I nominated myself (out of the group of 5 in the room) to go first because, well, if you are first you can be the most wrong, but if you are last, you better say everything as right as possible. We are supposed to say what feels like an introductory script and then we are first supposed to examine the breasts while movements are done, then feel the lymph nodes in the axilla...and then do the actual breast exam. I did an OK job with the actual techniques, but it was virtually impossible to make someone who was raised NOT to look at a woman's chest focus solely on someone's boobs while they lifted their arms up and down. I have to say it was a first for me to have someone say "WHERE ARE YOUR EYES SUPPOSED TO BE" and the answer be..."on your breasts". Yet, my biggest problem was...wording. When you are trying to describe to someone what you are going to be doing on their breasts, I learned the best way to say things is to be as technical as possible and use the word "examine". Saying to someone "...and then I am going to feel around on your breast and look for abnormal tissue" apparently sounds a bit uncomfortable. Sure, I had read the homework before and knew not to do things like call the table a bed, or worse, for the gyn exam which we have yet to do, say "you will feel me inside of you", but I had no idea how my normal ways of saying things were just...awkward. However, I might add, we were taught to say "you are going to feel my touch"...and I think that sounds just as bad.
All in all my experience was a good one for learning, yet I did have one major qualm with my GTA. If someone is supposed to examine your armpits...wouldn't you shave them? And, if you didn't, when a student asked if they could wear gloves, wouldn't you just let them? Just saying.
Anyway, following the breast exam experience (plus a few weeks), we had another session with the GTAs where we were learning to take a female health history. This was a good session for me especially because in the VA I have never seen a female patient and learning to ask about periods and menopause was lost on me. Each of us had to ask all of these questions on a check list to different patients, some VERY easy (no real health or emotional issues, just going down the list) and some VERY difficult. I always have a tendency to draw the difficult patients and this week was no different. To make matters worse, my patient was actually the same one I had for breast exam, and all I kept thinking was, I hope she does not remember me (and I hope she shaved her armpits).
As the doctor asking her questions I was doing well...until I asked her about her current sexual situation and found out she was a lesbian...and then 3 questions later asked her what she used for birth control. I immediately paused and put my foot in my mouth. CLEARLY she did not need birth control (immaculate conception?). She did, however, need protection/prevention of STD's and wording again came back to bite me in the ass. I spent the rest of the interview trying to make up for my stupidity by being hyper-sensitive to her emotions and veering off of the list of questions to talk about her financial concerns or her past emotional problems. Despite turning bright red in front of the 3 other students watching me, and being utterly embarrassed by my lack of thinking about what I was saying before I said it, at least I did not ask her "if she used sex toys"....which I heard another member of my class did. Sometimes I wonder how people like her get past the medical school interview process.
As the doctor asking her questions I was doing well...until I asked her about her current sexual situation and found out she was a lesbian...and then 3 questions later asked her what she used for birth control. I immediately paused and put my foot in my mouth. CLEARLY she did not need birth control (immaculate conception?). She did, however, need protection/prevention of STD's and wording again came back to bite me in the ass. I spent the rest of the interview trying to make up for my stupidity by being hyper-sensitive to her emotions and veering off of the list of questions to talk about her financial concerns or her past emotional problems. Despite turning bright red in front of the 3 other students watching me, and being utterly embarrassed by my lack of thinking about what I was saying before I said it, at least I did not ask her "if she used sex toys"....which I heard another member of my class did. Sometimes I wonder how people like her get past the medical school interview process.
No comments:
Post a Comment