Louisville Medicine Volume 68, Issue 7 | Page 13

PATIENT ONE AUTHOR Nicholas Chen
TRANSITIONS IN PRACTICE

PATIENT ONE AUTHOR Nicholas Chen

It doesn ’ t seem too long ago that I stood

outside the door of my first standardized patient encounter , heart pounding , reciting my greeting in my head , trying to digest the information on the door chart when the disembodied voice of our proctor came over the intercom , “ Students , you may enter the room when ready .”
One deep breath , then I knocked on the door and entered , feeling nervous and decidedly un-ready .
Two years later as I entered the room to meet my first real patient , I wish I could say I felt completely confident and assured , but I still felt a sense of uncertainty . After all , the experience would be a true one , unembellished , consequential and a significant milestone in my training .
There is something solemn about a doctor assuming the care of a patient . There is no contract either party signs , but when patients come to the hospital , they come to us with the understanding that we will treat them to the best of our abilities .
My first patient was an elderly man , Mr . D , with end-stage kidney disease and significant heart failure . He answered my questions begrudgingly and appeared to grow more disgruntled with me as our interview continued . I maintained a cheery attitude as I asked about his work and home life and then his family . At the end , I asked if he had any questions for me .
“ Yeah ,” he said . “ Just one . Why you askin ’ me so many questions ?”
I flushed . I apologized , explaining I was a student and part of my learning required me to take thorough and often exhaustive histories of my patients .
I sometime wonder what patients think when I introduce myself as a medical student . Do I appear at all competent or knowledgeable ? Am I saying the right things to make them feel comfortable and acknowledged ? Is it obvious that my outward attitude belies the uncertainty I feel inside ? These feelings were compounded as I tried to adjust to the new hospital environment .
By the end of my first week I had :
• Called my attending “ Mr .” instead of “ Dr .”
• Asked the nurse how to turn on a light in the room
• Played hide and seek with one of my patients after I forgot his last name
• Stood with my hands behind my back countless times
• Been told by a patient that I “ spoke English really well ”
• Resumed my first patient presentation after the attending ( continued on page 12 )
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