I met a dinosaur

SMS: lol I got the old man, fun.

I was told me about this old guy already, how he asked what my friend was doing in the clinic. My friend replied, I'm here to learn. Then later he joked about the paternity of the pregnancies in antenatal clinic. Haha. So being on time, or more on time than another student in my group, I had the great privilege of sitting in clinics with this man. He was in his eighties, thin white hair, neat shirt and pants, a vintage plaid suit, which didn't fit properly on his crooked and bent back. And the classic, old fashioned, rectangular leather briefcase that hardly anyone uses anymore. He was nice, and could almost be my grandfather. But his style was pretty unusual, and I had to hold my laughter so many times during the consultations.

"Now I'm going to examine your heart, which is under your left breast. Now I'm going to listen to the area above your left breast." Well, that's just making the physical examination more awkward than it needs to be for your lady patient. He asks another woman to get undressed for the vaginal swabs, and while she lies there waiting behind the curtains, he literally takes a good ten minutes or so to sloooowwwwly collect the equipment for the examination. "Just a minute, I will be coming in soon!" Then he takes another five or ten minutes to label the slides and containers. After she leaves he says, "oh my, we're not getting through these patients very fast, are we?" No, I smiled.

"G-l-u-c-o-s-e... 6 p-h-o-s-p-h-a-t-e... d-e-h-y-d-r-o-g-e-n-a-s-e... d-e-f-i-c-i-e-n-c-y... search." He uses two fingers to slowly type out the entire phrase. Hey, Google knows what you're searching for even if you type in the abbreviation G6PD. "Hmm," he scrolls down the page, "I should just click the first link that comes on the page right, right? Yes. Let me see, case report of hydops fetalis in G6PD woman, yes I will tell my patient this." Oh no, you don't know how to use a search engine? With patient in the room now, he says - "I don't know much about G6PD, there's some medications and foods you can't take right? But I'm not sure which ones." Wait, real doctors aren't that honest! Then he asks me whether he should send her to a haematologist, and I give a vague answer along the lines of it's probably not that important but it is a specialised field and it wouldn't be unreasonable. Then he asks again whether he should refer her on, not in a quizzing way but asking what to do next. I didn't say this out loud but - I don't know sir, you are the doctor.

"What is the day today? 28th of May?" Then he writes down 25/05/12 or something similarly wrong, and does this on multiple occasions. I corrected him once and he was quite thankful. But the next time it happened, I felt bad pointing it out again. Also, the antenatal record says "if Rh -ve then review...", and because the lady was positive, he goes and crosses out the Rh -ve and writes Rh+ve now so it reads, "if Rh+ve then review...". I wanted to point out, there is another box to write in blood group and Rh status.

 "Have you seen the midwife yet? No? You better see one for your next appointment, and talk about the midwife things that midwives like to talk about." I was trying to figure out whether he respected the midwives or whether that was supposed to be slightly mocking. I was also wondering whether he was treating me like a nurse, or was it that he was trying to get me involved, by not only asking me to prepare the gel on the ultrasound probe, and handing tissues to wipe it up, but even handing me the wet tissue with gel to throw in the bin, when the bin was right next to his hand.

At the end I thought, if we live and work for long enough we'll become a dinosaur, a museum relic, like this old doctor. Reminds me of the old surgeon who examined us for clinical skills in venepuncture, but had never seen a Vacutainer until the day of the exam, haha. I wonder how well we can function when we're more forgetful and slower, and would we be like these old doctors who can't keep up with tools of modern day technology? Not to be disrespectful of course - we've had many old but fantastic clinicians and tutors. Some have great medical knowledge, particularly thorough physical exam skills, and such interesting style. Who doesn't love the old fashioned suits and dark coloured doctor's bags with nifty equipment inside - it's as exciting and mysterious as Santa's sack.

I haven't written about the other lady doctor I've sat in with multiple times in clinic. She always walks in late to clinic, looking chaotic, and says that she needs to get herself organised. She has a coffee each Monday morning and says that she just went for coffee with her friend, and how she never has time to meet friends. Then she would proceed to change her runners into nice ladies footwear in an unladylike fashion. Then, though she wears visibly expensive doctor's standard (yes doctors dress like doctors, and it does get confusing when nurses and other allied health professionals dress well), she manages to be so tomboyish that her skirt is invariably crumpled and messy. This is from a lady who is older than my mother. Just a side note, she also behaves differently with to Caucasian patients. I've noticed that she makes sure she introduces me as a student, and explains the pregnancy issues in detail to the Caucasian ladies and don't bother much with the "ethnic" ladies. The other day we were told that men and women were treated differently in consult. Anyone know the findings on biases between how doctors treat their patients, and how patients view their doctors based on ethnicity?

Yes, I've just spent more energy observing and recalling the non essential details of a consult, rather than gaining medical knowledge. Maybe I should have studied something really artsy. Or go into something fluffy like psych in the future. Goodbye antenatal clinics, I won't miss you, at all.


joe said...

the old guy sounds like such a gem! only a person his age can pull off such classic heart auscultation instructions i think. so is this the end of your women's health rotation?

... and how's the photoshop makeup going? Haha. (i ask genuinely though -- believe it or not i've done a similar thing before for a photoshoot for a couple, so i sort of know...)

Hope everything else is going well, take k

-joe s

Winnie said...

hey joe, no I still a couple of weeks to go on women's. didn't change my profile pic too much, haha I feel it's sort of false advertising. haha I'm sure your skills at virtual makeup are much more advanced than mine :P

Ziph said...

that dinosaur sounds dangerous.

Mr. I don't know what a vacutainer is didn't seem that scary. (vacutainers are relatively new so I wouldn't be surprised if many other consultants hadn't seen one.)

Surely, its jut a matter of time before he misses something important and causes a serious problem if he hasn't already done so.
Fortunately, patients are reviewed by midwifes and other doctors. But still..

Winnie said...

yeah it's a bit unfortunate because I think it's more age related changes than anything else. I know you like to deny your mortality but we're going to be old one day too ziph :P

I'm sure you're right about that, but mr I don't know what a vacutainer is was marking our procedural skill. surely they could've got someone who was familiar with the procedure?

Grace said...

I really enjoyed how you observed and contrasted these two doctors with quite different styles!

Winnie said...

thanks grace :) it keeps me awake in clinic!


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