ShameI thought that medical officers should know better. On common courtesy, respect, empathy and ethics. More so if the individual is a specialist/clinical school lecturer.
I was wrong.
This morning, my friends and I had to clerk a 50-year old Malay man [let his name be X] during our hospital visit. A cooperative patient, X cheerfully told us whatever we wanted to know: on his main complaint(s), past medical history, family history and social history.
We found a great deal about him. That he is a busy man (he has two jobs to begin with, and has a relatively large family to care for). That he was diagnosed diabetic and hypertensive just last year. That he is on oral medication to control his ailments. And that he OPENLY admitted he was a social drinker during his hey-days, and stopped drinking since 1984.
Can one imagine how difficult it must be for him to actually talk about his (past) drinking habits? The fact that he openly said so to us not only implied he was courageous enough to do so, he trusted us completely. Hence one of the reasons why we SHOULD TREAT OUR PATIENTS WITH OUTMOST RESPECT.
Then along came a certain Dr. Z (a foreigner by the way), who was to guide us during our bed-side teaching. I shall not elaborate so much on what he/she had done, but the following were three (grave) mistakes he/she had made in our rounds:
1. Did not greet X, nor introduced himself/herself to him.
2. Commanded us to start presenting his case, in front of X, without even looking at him.
3. Commented loudly (and quite harshly) on his history during case-presentation, assuming that X does not understand English.
Two significant examples to illustrate my 3rd point:
a) On past medical history:
Student 1 : X is diagnosed as diabetic and hypertensive one year ago, and is currently on oral
medications....
Dr. Z : And what about the medications?
Student 2 : He doesn't know the name of the drugs. He only knows that he has to take one large, white tablet and another white but smaller tablet everyday.
Dr. Z : Oh I'm sure he doesn't know the name of the drugs....his IQ isn't high....
What the.....???!!!!!
b) On social history:
Student 1: He admitted that he drank occasionally between 1979-1984 whenever he went out with his friends, but has stopped completely since then...
And in a very loud voice, oblivious to the number of people in the Ward...
Dr. Z : Okay, so HE'S AN ALCHOLIC FOR 5 YEARS!!
I rest my case.
X was naturally offended by his/her remarks, and felt he was publicly humilliated. Dr. Z was still unaware when X later got up from his bed and walked to the other side of the ward, refusing to listen anymore. The good doctor only realized his/her folly only when X refused to be examined, stating himself very clearly in Bahasa that he was very much insulted and demanded an apology.
[note: Being a foreigner and a new teaching-doctor, Dr. Z does not know Bahasa, so we had to translate what X had said]
Okay. So Dr. Z might be new in Malaysia, and thus he/she may not be aware of our religious and cultural backgrounds. However, that is not an excuse for his/her improper conduct towards X. Where was his/her etiquette? Surely the good doctor must have been brought up at one stage to RESPECT other people, regardless of the context.
X was still unhappy despite the apologies....
That is understandable.
Dr. Z? He/she was pretty much shaken after this episode.
Hopefully this would be his/her last.
To the other doctors/medical students, let this be a valuable lesson for all.....
Behold the medical school nerd scale I've found on the Net! So what would your score be? =)
NOTE:
The following scale has been developed in close cooperation with the UVA psychiatry services (Well at least I was thinking of some of their characteristics and used some of their class time to compose it). It is designed to test if you have spent too much time in medical school and whether you are having adverse side effects due to prolonged exposure.
[WARNING: there are 100 points altogether. you've been warned...]
Score one point for each statement that applies to you.
1 You have ever said "Netter is God"
2 You can discuss autopsy/ anatomy over a meal
3 You own a 4 color pen
4 -it just isn't enough colors for you
5 You use more than one color to take notes
6 You have use up more than 6 highlighters in the past 6 months
7 You have ever highlighted something YOU wrote
8 You retype handouts given in class
9 You haven't had a date in 3 months
10 You haven't had a date since entering med school
11 You have not been able to remember the normal term for something because you were thinking of the medical term (eg: reflux for heartburn)
12 You get more sleep in lecture than at home
13 You know the correct spelling for pruritus
14 - you also know what it means
15 You have ever asked a question in class
16 - the prof. didn't understand the question
17 - you didn't believe the answer the prof. gave
18 - you went to look it up to see if they were right
19 You can't hold a conversation on anything other than med school
20 You skip class to study
21 You've said you didn't do well on a test on which you beat the mean
22 You spend more than 15 hrs a week on e-mail
23 You have a callous on your finger from writing
24 More than one professor knows you by name
25 When you ask a question, a new professor has said "Oh, I've heard of you"
26 You can name more amino acids than past presidents
27 You use more than 5 acronyms an hour when talking
28 You actually know what PERRLA stands for
29 You know all the steps of the TCA cycle
30 You do not read PTA as parent teachers association
31 You can remember the muscles in the forearm
32 You know the strucures in the urea cycle
33 You know the dermatome distribution
34 You can't remember what you had for breakfast
35 You can't spell world, much less backwards
36 You've ever been sexually aroused by the breast shadow on an X -ray
37 You equate "morning stiffness" with Rheumatoid Arthritis
38 You actually know normal values for plasma Na
39 - and for plasma K too
40 Missing class causes you extreme stress
41 You have seriously asked someone "So how does that make you feel?"
42 You have asked will this be on the exam
43 -just after the prof. said it wouldn't
44 You identify with Deb on E.R.
45 You have made a medical joke
46 -no one laughed
47 -you figure they just weren't that far in their studying
48 You wear your stethescope around your neck on the bus
49 - you don't even know which way the thing goes in your ears
50 "SOB" means short of breath to you
51 You have gone to student health with suspicion of a disease you have studied
52 -within 3 days of the lecture
53 You have answered a question in class
54 -asked by the professor
55 -....it was a rhetorical question
56 You can quote lines from the movie "Malice"
57 -you believe them
58 You can flip your pen over your thumb
59 - with both hands
60 - you do so throughout class
61 You have corrected a professor in class
62 -the rest of the class didn't understand the lecture to begin with
63 You know how to calculate specificity
64 -positive predictive value
65 - anion gap
66 -you can't balance your checkbook
67 You don't know what the weather was like for the past week
68 -you don't know what the weather is like right now
69 You actually talk in open ended questions
70 DIC isn't a slang term for the penis in your book
71 You think B- is a bad grade [hahahaha!!!!]
72 You have stressed out about a pass/fail grade
73 You study during most of your meals
74 You saw nothing abnormal about the Obsessive-Compulsive Disorder
75 You draw all of the slides not already provided in the handouts
76 -including the cartoons (humourous type)
77 Anatomy makes you hungry
78 You would even consider saying "Ease back on my finger at your own pace"
79 You know the size of a RBC
80 - you don't know the size of a football field
81 Your eyesight has worsened by 10 pts or more in the last year
82 You have the library hours memorized
83 You have your own seat in the library
84 You score more than 95 on the Epidemiology final
85 You own more than one white coat
86 You have debated between giving up sleep or eating in order to find more time to study
87 You started studying for boards more than 2 months in advance
88 You have never received a personal invitation to discuss your grades with the dean
89 A tie is the only addition necessary to what you normally wear when you go to see patients
90 You wear scrubs to tests
91 You have made plans to study on a beach during vacation
92 - you actually did
93 You have a designated seat in lecture
94 - you have ever asked someone to move from "your seat"
95 You sleep less than 4 hrs a night
96 -you think that is plenty
97 -you have thought about cutting back
98 You study more than 35 hrs outside of class
99 -you think you are a slackard
100 You think everyone answers yes to most of these questions...
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Scale:
<20 You're not in Med school. Go back to your party and leave us alone. We have work to do.
20-35 Either Med school is a breeze or you like the sound of "Senor doctor"
35-45 Gotta love that Primary Care
45-60 Well, I never really thought about MD/Phd, but now that you mention it...
60-75 Your social life is shot, might as well try to earn lots of money
75-90 Which surgery subspecialty did you say you liked?
>90 All hail great Med School Nerd master!!!
