PRACTICING AND LIFE
MEMBER CATEGORY
WINNER
2015 RICHARD SPEAR, MD,
MEMORIAL ESSAY CONTEST
THE UNEXPECTED IN FRONT OF US
Nina Vasavada, MD
I
pick up the manila chart from the rack
outside the examination room and read the
chief complaint, “Headache.” It is a Thursday afternoon, a few weeks into my third
year medical student internal medicine
rotation. The newness of it all and the breadth
of disease processes still overwhelm me. I tap
on the door twice and open it, cautiously and
apologetically. I suspect that many patients are politely tolerating
my novice and amateur inquiries until they can see the attending
physician, their consultant, confidante, and dare I say, friend.
The patient is a young woman, just a few years older than I. She
notes the frequent onset and worsening duration of migraine headaches, and has been requiring high dose pain medicines to provide
relief. I ask questions which might be pertinent to a neurological
illness, and conduct a focused exam. We come up with a satisfactory
plan for her chronic headache management. I step out of the room
while the attending physician speaks to her alone. Soon after, she
thanks us as she leaves the office. I muse at how straightforward
the case was, and then go pick up the next patient chart. Friday is
another pleasant yet busy workday full of varied clinical dilemmas.
Having no major responsibilities other than my own education, I
enjoy a rela