Summer Facelift - What's New at Vitum Medicinus

Summer
+ job supervisors kind enough to realize that this is my summer
= free time to do some tune-ups at blog.vitummedicinus.com.

You may not have noticed all the upgrades, especially if you're reading VM in a RSS reader. In order that you don't have to pore over the blog looking for them like a radiology resident scanning an x-ray film (I had to tie in that photo somehow), here's the improvements listed for you.

• New Blog Header Photo
  I had to change it anyways since I grew a year older since I started this blog; but I figured I might as well change the photo to something that actually happened in medical school, rather than something I did during my pre-med years. This photo was taken in a hospital on my cell phone camera when a bunch of us were waiting around for a pediatric clinical skills session to start. My favourite part of it is the subtle tribute to Canadiana - there's a Tim Horton's coffee cup sitting on a table in the photo.

• Favourite and Most Popular Posts
  a.k.a. Vitum Posticles Popularis, now available in the right-hand sidebar as an easy springboard for anybody who wants to read the best of VM right away. None of the fluff. Just the top stuff. Favourites include First Post, First Breast Exam, and the Top 10 List Category.

• Feedburner RSS Feeds
  By becoming an RSS reader user I developed a lot more respect for those who use RSS readers, especially those who read VM via RSS. I also developed a healthy bit of embarassment at this up-until-now-ignored aspect of my blog, and now that I've delved into the world of RSS I added Feedburner RSS feeds to maximize the functionality of my feeds. Subscribe to Vitum Medicinus via RSS... or get a Feed Reader (Google Reader is great).
  

• E-mail Updates
  For those of you who, like me, are reluctant to jump head-first into RSS without really understanding it, you may prefer to get VM posts e-mailed to you whenever they're written. If so, you can subscribe to VM via e-mail.
  

• Polls & Poll Results
  You can now view all polls that have been hosted at VM, and vote in any of them or check out the results. Jump to polls...

• Grand Rounds Hosted at VM
  VM had the privilege of hosting Grand Rounds for the first time; version 3.43 was hosted here on July 17, 2007. Reviews include "best GR in recent memory, there, I posted that for you, now where's my cheque?" and "you put way too much time into this." Jump to GR...

• Post to Facebook, del.ici.ous
  For those of you who care about your friends enough to share a VM post with them, you can now post a VM story to Facebook or del.ici.ous thanks to the convenient links at the bottom of each post - whether you're reading it on VM or in RSS.

• New to Medical Blogs? Vitum's Guide for the New Medblog Reader
  Okay, this one is kindof just another post on VM, but it's included because it's a tool for people who - like me just over a year ago - don't know Web 2.0 from a medblog. Especially important now that I've indicated that reading medblogs is important for any pre-med. Check out Vitum's Guide for the New Medblog Reader.

If you have any more suggestions on how I can improve your VM reading experience, please let me know by comment or via e-mail - and thanks to those of you who have been kind enough to bear with me as I tinkered with the settings of VM, or have suggested improvements already.

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"Oh, you can come in for this, it's not a breast exam."

It turned into a breast exam pretty quickly.

I was at a family physician's office for my mandatory Family Practice class. I'll be going 14 times this semester. Typically its the one time each week we 1/8th doctors can actually put on our humbling little short white coats (white enough to look doctor-ish but not long enough to look cool - especially for guys), fling our hardly-used stethoscopes around our necks, walk proudly into actual clinical exam rooms, and see real, live, sick people. Maybe ask them a few questions. And hope not to get sworn at by patients (speaking from experience here).

It would be anything but a typical day. I was told that my clinic partner, being of the female gender, would be interviewing the next patient. 'This patient is here for a breast exam,' said the doctor, "so Vitum, maybe you can sit this one out." I didn't mind. I was entirely used to - and comfortable with - not observing something like this until I have been well-trained in the process.

My clinic partner interviewed the patient briefly, then came out of the room and described the patient's complaint as a lump below her left breast. The doctor told me: 'Oh, Vitum, I suppose you can come in for this, then; it's not a breast exam.' He checked if it was OK with the patient and it was. In I came.

It turned into a breast exam pretty quickly.

I'll admit that a while ago I was a little nervous about how I'd end up doing my first 'intimate' or 'gender-specific' examinations - nervous enough to do a bit of research on the subject. After doing Google searches using creative combinations of the search terms "medical student," "breast," "exam," "vaginal," and "how the hell do male students not show signs of awkwardness or even arousal when being taught to perform professional medical exams on patients," I censored my search results and carefully chose a link and hoped to find something telling me something of the process.

I got lucky. I ended up reading a well-written article by Jules Lipoff, a second-year medical student at the Albert Einstein College of Medicine entitled "Dr. Strangeglove, or, How I Learned to Stop Worrying and do Breast and Pelvic Exams." That article appeased some of my misconceptions about training in these areas. While I had initially pictured being herded into a patient room at a hospital with 7 other medical students following a resident or attending physician and being instructed to 'check out' a patient, one after the other, I was relieved to see that the article addressed
a) thoughts...of ...and during ...the experience,
b) the fact that medical schools work hard to increase professionalism and minimize awkwardness by using trained clinical educators, from whom medical students gain both insight and practical experience, and
c) the fact that students have fair warning about when their first exam of this nature will be (the students in the article were given a month's notice).

I didn't get a month's notice. "We might as well do a breast exam since it's been a while since we've done one with you." The patient consented a little too readily.

When something happens in front of a patient that's a little shocking, as a medical student with common sense you know it's not right to make it obvious that you're going through mild forms of shock. So I hid my surprise at the fact that I was not expecting to watch a breast exam, and yet now, here was one being performed, right in front of me. "Use this part of your finger and go in little circles," said the doctor. "They say to spend five minutes on each breast when doing an exam, but I never have time for that in my practice." I didn't catch much else. My mind was busy reeling from the situation.

Fortunately, the patient didn't add any awkwardness; she was totally fine with the whole situation and was chattering away happily about the history of her originally "A-cup" breasts, her choice to acquire implants, the rupture of said implants, the removal of said ruptured implants, and subsequent natural growth of a well-endowed pair after said removal of said ruptured implants.

My mind continued reeling. In fact, I was still getting over what I was watching when the doctor turned to me and said, "Vitum, your turn."

Damn.

I'm not sure how well I hid the shock that was pretty much taking me over at that time. It was enough to watch this. Now I was expected to monkey see, monkey do. What was I going to do, say 'no'?!

So, somehow confidently, I stepped forward, and reached out, and put my hand down on the breast of a woman whom I'd never met before, a woman that was old enough to be my mother. I still have to get used to how much nakedness doctors see. I began moving my hand around in circles, like I'd been shown. I also began thinking to myself, "Think professional thoughts."

Looking back, I don't think I did that for more that about six seconds before I stepped back to let my clinic partner have a go at it. "No lumps?" said the doctor. My mouth made some sort of a sound, and the doctor replied, "Good!"

So that was my first breast exam. Yay for me for reading up what my first clinical breast exam would probably be like, and yay for it being absolutely nothing like that.

You never forget your first time, do you... especially if it's as unexpected as that.

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