Last Friday, my batch (first year) had its first hospital exposure at Batangas Medical Center. It’s a government run hospital near the city hall of Batangas City.
We were asked prior hand to wear our uniform and our short white coat and to bring the necessary things we need to be able to perform a history taking and physical examination. I didn’t bother bringing my own clip board so I borrowed from my roommate. I should have brought a notebook or extra pieces of paper to write for the history taking which I didn’t expect.
From AUP to Batangas Medical Center (BATMC), the school has it’s own van and for our class we were divided into three vans. I was in the first van and no harm happened. Sadly for the second van, it overheated so bad while in Ibaan, Batangas (quite near to Batangas City maybe few towns away). So my classmates who rode that van were late in being able to conduct history taking and physical exam to our assigned patients.
Before we went off, I was initially anxious because we needed to act as real doctors already, really establish rapport and perform the necessary skills (because our accompanying licensed doctor would grade us through some assessment forms). But at the end of the day, I didn’t saw him made any remarks on our assessment forms so I wonder how he will grade us with what we have done that day (though we will pass an individual written report of our patient, I still don’t know how he will grade our actual performance).
While at the van going to Batangas from Silang, Cavite, I can’t help but feel anxious and slight pain in my abdomen maybe because I am not used to riding vehicles again and maybe I was hungry. The trip to BATMC was so long maybe almost two hours. I didn’t expect it to be that far.
Then when we arrived there, we were briefed on what to do and what to accomplish. We were grouped by count-off. And it so happen that I was grouped with people I can say I’m really close with. I initially volunteered on doing the history taking being not so confident in performing physical examination. The assigned patient to us as a group was a male. He was just 23 years old and his case was a respiratory problem. His bed was just along the wide aisle not in a room and near the fire exit. At the time we approached his bed, he was sleeping. But prior to approaching his bed, there are other beds in the aisles and when we passed by they acknowledged us as real doctors (even if we are just student doctors). The leader of my group greeted everyone in that hallway and I admired his courteousness. While me on the other hand who is at his back wasn’t even greeting the patients nor smiling that much (poker face, sorry >.<). From now on I’ll try to be more smiley and courteous to patients (even if they are not the ones assigned to me).
Going back to our patient, we were embarrassed to wake him up but after few minutes we muster the courage to wake him up (I made our male leader to wake him up so it won’t be too awkward if females in my group would wake him up). And we introduced ourselves as student doctors and our names. Then my leader asked his general data and his chief complaint. While on the other hand I tried to probe him in the history of present illness, past history,personal, social and family history. How I wished I had more paper with me so I was able to write more organized and how I wish I can read my Bates book while doing history taking. But no! I learned from that moment that you can’t read your kodigo or read from your iPhone the ebook of Bates. So I relied on my memory what are the things needed to ask. After the whole history and physical examination which took us almost an hour, we prayed for the patient and bid him goodbye and ‘pagaling po kayo! / get well soon’. Our whole interview with him was mostly in Filipino.
During our preceptorial with an internist initially then a pulmonologist (it should have been the pulmonologist but she was late so the internist sat with us during preceptorial like a small group discussion), we presented the case but we weren’t eloquent enough yet. We missed out asking some questions. And I realized we probe questions in a wrong way. Instead of asking ‘do you smoke’, it should be ‘how many sticks of cigarettes do you use in a day?’ Our internist said we should be direct to the point sometimes because most patients want to deny the truth. Also I should have asked ‘is there anyone in your family who has inheritable diseases?’ instead of ‘does your parents have diabetes or hypertension?’ Because our patients answer was almost negative as if he wants to convey that he’s okay, nothing is ailing him or his family. So I was a bit doubtful on the truthfulness of his words. (Someday I will be like that internist who listened to my group’s case during that last Friday’s hospital exposure.)
Then after the preceptorial, we went out and waited for the AUP vans to arrive. Good thing there were small stores near the hospital and I bought banana cue and royal soft drinks. I also bought for my leader (he is like an older brother to me) some snacks. While at the van going home back to Cavite, all of us inside the first van made fun of my male classmate (the one whom I said was my group’s leader and like an older brother to me). Actually he is like an older brother for everyone of us in the class. It was such a good laugh while going home. The trip going home almost took 2 hours or more I think. Then when we arrived at Paseo, our clinical instructor (a licensed doctor who facilitated us), went back to Medical City Paseo. Some of my classmates who rode with me in that van went eating in Paseo. The only ones left going back to the campus were like five us. Since we arrived in AUP past sunset meaning it’s Sabbath already, they all went down in front of PIC (church inside the campus for Adventist people). Since I am not an Adventist, I went home to my dorm and good thing the driver of the van drove me to my dorm. My dorm is located down the slopey hilly road (down from the main road). So I told the driver that it’s alright that we won’t go down that slope anymore. And so I walked down that steepy slope. I did so many others things that night.
I have so many learnings from this experience. One, you should bring clipboard and extra paper to write on. Second, read on Bates for the proper taking of history and performing the physical examination. Third, always be courteous and smiling to all the people inside the hospital. Fourth, never show your phone in front of the patient (so I really need to know by memory the things I should know). Fifth, construction questions in leading but open ended way so no biased or denying answers from the patient.
In a week to come, I will be needing to pass an individual report (history and focused physical examination of the patient huhu).