Updates from the Field

Well, all has been well in my little world lately. I had the pleasure of going home to Seattle for the weekend to celebrate my best friend and my sister's birthdays. If Ambur ever gets around to sending me pictures of our night spent drunkenly scootering all over Mercer Island, I'll post a few on here. Otherwise, you'll just have to use your imagination. My sister's brunch celebration was notably more low-key, but just as enjoyable.

At work, things are going pretty smoothly. The schedule seems to have picked up a bit and I'm quite a bit more busy, especially when I'm writing 90-100% of the notes each day. The preceptor and I are getting along much better and even discuss politics now and then. He has made a few comments in the past week or two about the amount of workload I've taken on and my taking initiative...I appreciate the recognition more than he knows. In turn I've been asking him more questions and seeking out his advice more often, and I seem to be awakening the teacher in him a bit more. He's done a better job of explaining his decisions lately, and I appreciate that too.

I've also seen a few more interesting patients. Most excitingly, I got to see my first well-child check yesterday. It was on the sweet little 2 month old I saw last week for a URI. Turns out WCC's aren't nearly as daunting as I thought they might be. Still, I need to brush up on my milestones so I know what to look for more specifically. Also, today I got to see a sweet little 7 year-old girl for eczema. She had eaten some blueberries prior to her arrival, and they'd stained her face from the nose down. I praised her for making good food choices.

Yesterday I made a cop almost vomit after illiciting "intense" pain when I palpated the sciatic nerve tract down into the superior buttock region. Strangely, he'd never been diagnosed with sciatica...

Then there was the 30-something muscley manly-man who came in and was on the recieving end of a 5mm punch biopsy for a dermal cyst. Poor guy looked like he might faint just thinking about the procedure. Some sweat (on his part) and lidocaine later, he was quickly sutured up and sent on his merry way.

My favorite encounter of the last week or so, however, was a woman who was coming in with severe anxiety. She was mid-thirties without a history of depression or anxiety. Some situational life stressors, however, had left her with some pretty severe palpitations, racing thoughts and chest pressure. She was crying during the appointment, and mentioned a few times that her husband thought it was silly to use medications and that they were just a band-aid, but she couldn't handle it anymore so was coming in for some help. Just as the appointment was ending, the nurse announced that her husband was here....a surprise to both the patient and I. The patient asked me to stay and help explain her situation to the husband....

He was open and honest about his belief that medications were not necessary to control one's stress. Still, he listened to me as I explained her acute stress reaction, the physical toll it was taking on her, and how a short course of medications could help get her back on track without becoming a permanent crutch. Now, I really don't think a word of what I said made him change his mind or think differently....but his wife was SO thankful to have that conversation with some help from a medical (student) provider. I was a little overwhelmed and probably looked a little nervous, but I got through it and felt as though I may have actually helped (a little).

So, while the majority of the patients I see are still sinus infections and back pain, I am learning to enjoy the little quirks of family medicine. It isn't everything I hoped it would be, but that is just at this clinic. I still consider it to be one of my top three choices for practice specialty, along with dermatology and something else yet to be determined, (peds? cardiology? urgent care?). I'm still waiting on what my elective rotation will be....

Sending love out to my fellow PA students as we hit the halfway mark of clinical rotations,

Jen