Pediatrics Skills Workshop

Through one of the student groups, the Pediatrics Interest Group (PIG), I went to a pediatrics skills workshop for M1s and M2s. There were about 30-40 students there total, and we were divided into smaller groups to rotate through several stations.

My first station was a well-child physical check-up. Two pediatricians brought in their kids for us to learn/practice check-ups on. They were such good sports about it (I don't think I would've been such a good sport unless bribed, hmm . . .). One kid was 4-years-old and he was seriously one of the cutest and most adorable kids ever! When his mom was demonstrating the physical on him, she asked, "What's that spot on your neck?" And he said, "It's my special spot," referring to a dime-sized birthmark on his neck. That was precious; he reminds me of my little cousin.

Alas, I didn't get a chance to play with the 4-year-old. The kid I worked with was 7-years-old. It's all good. After the pediatrician finished demonstrating on him, she asked him to pick who got to go first to examine him. And he chose me! ^_^ In general, you do a physical exam from head to toe. So I kinda massaged his head and neck to make sure everything was fine, no weird bumps or massive lymph nodes, then I listened to heart and lung sounds. I'm not sure exactly what I'm listening to because we haven't formally learned yet, but it's all good. Then I got to listen to bowel sounds and then my favorite, the liver scratch test. So with the liver scratch test, you put your stethoscope where you know the liver is. Then you lightly scratch the stomach closer and closer towards the liver until you can hear the scratching sound. Once you hear the scratching sound, you've found the inferior (lower) border of the liver. Pretty cool! I took someone's hammer and did the knee reflex . . . on myself - that was fun.

After that, we went to the immunization session where we learned how to give injections into muscle and subcutaneously. Ugh, I had issues getting rid of bubbles in the syringe - they just wouldn't float and go away!! It was pretty bad when the pediatrician at that station laughed at my incompetence with needles, lol. I think this is a sign that I shouldn't be giving injections to anyone (at very least, not in the near future).

Then the last station was the airways station. Personally this was my favorite one. We were shown how to use a laryngoscope to intubate (stick a breathing tube down the trachea) the airways on a child dummy. When I first put on the air mask, the pediatrician noticed how I was holding it wrong and remarked how I must've played the piano. o_O She said she used to play piano for many years, and that I was the first person to have held the air mask the way I did. Now, all laryngoscopes are left-handed tools, so I was excited since I'm left-handed; so was the pediatrician, so we were both quite excited. ^_^ It was also funny watching the right-handed people use the scope wrong before being corrected. Fail, lol!

Lastly, some of us returned to the first station that we had missed. It was doing a well-baby check on a SimBaby (a fake simulation baby). The SimBaby is really cool in that it can simulate different heart sounds, lung sounds, cries, pulses, can turn cyanotic (blue), and can even seizure. When we heard that, Keli - from the anatomy lab table across from me - and I exclaimed at once, "Omg, it has a seizure button?!" Let me say, seeing a seizing fake baby is kind of funny. But, if you mentally transpose that seizing onto a real baby, I think that'd be scary as hell. We thought it'd be really mean if, during some clinical test, someone pushed the seizure button while you were working on the SimBaby, because then it becomes an "Oh shit!" moment.

All in all, this was totally the highlight of my day. Keli and I spent some time just staring at the kids because they were so cute!!

Backlog: 12-01-09

Read more...

The Spirit Catches and You Fall Down

So it seems I'm failing at this "post weekly" thing. Hopefully this will be the first step towards remedying that. Anyway, you'll see at the bottom of some posts that say "Backlog: date" in red, indicating when that event actually occurred (and not when I posted it here).

-----

In undergrad, I took an amazing course called "Anthrcul 344: Medical Anthropology." One of the books we were required to read was The Spirit Catches You and You Fall Down by Anne Fadiman. It's about an epileptic Hmong girl and the narration of her story from the worldviews of both her parents and her doctors.

In early November 2009, Anne Fadiman came to give a guest lecture at my med school! Of course I had RSVP'd for this like a month in advance - and the auditorium hall was packed! I mean, how could I miss the opportunity to meet the author of a book that captured the beginning of a cultural shift within the medical profession? How could I miss an opportunity to hear what pearls of wisdom I may gain from this lecture, especially as I'm on the Hmong Health Education Program (HHEP) committee here? How could I, as a med student, not sit in on a lecture so relevant to cultural competency to aid me in better caring for a diverse patient population in the future (especially since cultural issues largely aren't discussed at length throughout medical training)?

It was a great lecture. She was more down-to-earth than I had envisioned. She discussed the conflict that could occur between two cultures due to mis-communications. Indeed, there is a medical culture that contains within it almost everything you'd expect of a culture - it has its own hierarchy, it's own rules, it's own language, it's own special clothes, it's own rituals, and it's own worldview. One thing she said that will stick in my mind is the idea of a Venn diagram of patient-physician communication. There is always overlap, however small. Sometimes the patient, sometimes the doctor, often both, must venture to the periphery of their circles into the area where the two circles overlap - to where there is common ground between patient and doctor. This overlap is (apparently) called the "lune," and we must seek it as both patients and doctors to promote maximal outcome.

Afterwards, I had the luck (and patience) to have her sign my book! Okay, I actually left my original copy back home in Michigan. But an M4 (incidentally the M4 who started the HHEP) gave me a free copy of her book for the signing, so now I have 2 books and one of them has her autograph!! She drew that Venn diagram in my book, reminding me to find the lune. I also got to take a picture with her. This must be the first time I was so close to a celebrity, lol!

Me, Anne Fadiman, and Jenny (fellow M1, also a UM alum)

Her work is well-known in medical anthropology and in the medical community. To think that a journalist would have such a profound effect on the way physicians, bioethicists, and anthropologists would view cultural differences within medicine and how those differences impact healthcare - sometimes for better and sometimes for worse.

Backlog: 11-02-09

Read more...