And then she heard it.....

As the day started i didnt think things were going to go too well...my first patient refused to speak to me and would only speak to the Doctor, i told her the Dr would be in after i got some information from her first..unfortunately she told that she would only disclose information to the doctor and that any questions i asked, would not be answered so i am wasting my time. She is going to wait for the Dr.

At first I was a little annoyed. I was just going to ask some questions, and listen to her heart nothing too invasive or personal and she would still get to speak with the Doctor. But the Doc made me feel better and told me not to take it personally. She had a lot going on and was a complicated case, and its ok if he just deals with her and we can move on to another patient.

I saw some more patients and then we left and went to the hospital.....unfortunately the women in the hospital is very sick and her family is probably not helping her situation. While the Doc spoke with the family member, i listened to the patients heart...I finally noticed something....i heard my first murmur in an actual patient (not a computer or a simulation but a real patient!!) i was asked to describe what i heard.....

a normal heart sounds like = lub dub lub dub lub dub
what i heard sounded more like = lub..shhh dub lub..sshhh dub

when he asked me what i thought was causing the murmur i answered, and he agreed with my assessment. Its seriously moments like that when i get excited at some of the skills i have acquired.

Today was another learning day, we discussed my reading assignment, "smoking and alcohol" again i had a decent day of getting questions correct. As with most medical students we like to be correct and hate to be wrong...i have been wrong a lot but at least when i am put on the spot in front of a patient i have been getting the questions correct and dont look like dumbass. I hate looking like a dumbass in front of the patient, alone in the doc's office i dont mind, just not in front of others....welcome to medicine, probably the most vain profession after modeling.

most of the patients we see dont mind having me take a history and do a quick physical so it reassuring, esp when they make a comment to dr telling him what a thorough job i have done. And how well i have treated them.....its just a start...

nothing else to exciting has happened today, my roommate is on call again so i am have the apt to myself tonight :)

tomorrow's reading assignment is "heart failure" so as you can imaging there is a lot of reading and i have to be at work by 8am ready to be quizzed....so i have to hit some books


btw - if you have not seen the movie SICKO do not pass go, do not collect $200 and go and see that movie!!!


Until you have seen this movie, esp if you want to discuss healthcare reform, healthcare in general or the practice of medicine..... if you happen to be a conservative who voted for Bush (although i seriously doubt that is the case, since i am not on speaking terms with most of those people) go and see this film...
Moore doesnt point the finger at the conservatives, he doesnt indoctrinate his liberal ways onto the movie goers, instead i think he tries to point out a problem, and provide a framework for dialogue about the problem and solutions....something that the republican party and the democratic party have not been able to lately....



if you know me, then you know how i feel about political dialogue....
Do not enter the conversation if you are not educated on the subject matter. Do not enter the dialogue with only personal opinion and emotion. Be sure to take responsibility for your own democracy and freedom and prove why want to live in a democratic society. Have an opinion, educate yourself, educate others and mobilize for change!!

there is only one way to change to the world, and that is to get off your lazy American ass and do something about it!

enough of the rant from me....if you dont agree please feel free to comment and tell me why!?! i enjoy a good debate...helps to filter out a better argument. Let the Discussion Begin...