I spent the morning listening to four different first-year students do their first-ever patient interview. Their previous practice consisted of interviewing a patient as a group (!). The patients were a group of retired folks who have been doing this for years. They do a great job of sounding natural and conversational, and responding in a way that’s directed by the student’s questions and manner, even though they know very well what are the important points in their history, and they can always tell when something has been missed.

One student reminded me completely of myself three years ago: frightened-looking, a little awkward, but pretty sure of where she wanted to go with the questions, and finishing very early. Most of the students were pretty good at remembering all the things to cover in a history (they’re not allowed to have notes or a template to start from). One student, however, worried me. He was African, with a thick accent – which complicates things to start with. Then, his patient was a lady with chronic pain, and a couple of very traumatic events in her social history. I knew, because she’s a legend with the students, because of the difficulty of interviewing her correctly, and because by this time I can read telegraph signs pretty well. The poor guy, however, stumbled along: “Do your allergies cause you any pain? Well, yes, I understand you take darvocet on a regular basis for your nerve pain; but how about your headache pain? On a scale of 1-10?” She interjects that the scale is meaningless because of the degree of pain she’s used to, and he keeps right on going, “But with 10 being the worst pain you have ever experienced, how would you rate your headaches?” And on and on; the climax was when he, dutifully, as drilled by the first-year classes, attempted to take a sexual history. Let’s just say that between this lady’s handicap, her stable marriage, his medical lingo, and his accent, it was a very difficult five minutes. I felt obliged to apologize and thank her afterwards, while also, in a separate room, commiserating with him for the difficult subject, but trying to encourage him to go with the flow, and (not in these words) not torture the patient’s story to make it fit your plan. I’m sure he’ll get better with a little more practice, but I wish I could hang on to him and try a couple more patients, right now, to make sure he gets the idea.

I drove back and forth with a girl, shorter than me, who wants to do orthopedic surgery. I have to admit, if any woman is fitted for the job, she is: very very competent, very very efficient, and determined to be part of the guys’ gang. We discussed peculiarities of different programs, the place of PAs in a teaching hospital (conclusion: not to scrub in instead of students, ie us!), and more.

Fun morning; one sure confidence builder is to watch people who are worse at something than you are. The clinical professors here do an amazing job of teaching wide-eyed novices to interact with patients in a competent style. Of course, the people I really need to compare to are the interns, not the younger students. I’m sure this is going to seem stupid later, but right now, with all this studying, I feel ready to tackle being an intern. I wish we could start now. I don’t want to have to wait another eight months, doing outpatient/medicine stuff. It’s going to be too easy. . . (famous last words).

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