Nearly two and a half years, countless exams, memorization of
facts and figures, pathologies, prescription drugs, and maneuvers
that scare you to death -- and you think you might actually know
"something" (but not everything). And then the first patient walks
through the door and you realize nothing you could've possibly done
thus far could have prepared you for what you're about to
experience. Welcome to being a student physician.
Throughout my various collegiate undertakings, I've felt
ignorant. There was never much of a point to thinking I knew
everything or even all that much because I was constantly reminded
that whatever bits and pieces I've pulled together meant only a
drop in the bucket toward what's out there. I hate feeling
ignorant. Maybe that's why I'm constantly reading and researching
-- because I know that I don't know anything.
Ricky in Radiology Positioning class
(Special thanks to Dave Aiello and Ricky King for this
Dr. Harrison, our clinician, brought up an excellent point last
week (he has LOTS of amazing pearls of wisdom). He said that the
stuff that we learn the best is the stuff that we're faced with. If
there's a condition that we, a family member or friend, or a
patient has, we WANT to learn about it. And so we learn those
things the best. But when something is sitting right in front of
you, there's this overwhelming need to know it -- right now.
Sometimes that learning curve can be pretty frustrating.
Questions get asked. Tell me about your family. How are you
feeling? What's going on in your life right now? Can you describe
this or that sensation? As the physician, you're supposed to know,
not only what it is they're talking about, but also how to put all
of it together to make sense of what is in front of you. It's a
complex task. Then you have to take the person in front of you, and
figure out how to make them better, take away the pain they're
having, help them cope with what's going on in their life, and help
them re-enter their space of wellness. And of course, you hope that
they're working with you on this. This takes skills they don't
teach in school. We can take all of the interviewing skills
sessions, basic and clinical sciences, and psychology classes and
still not be able to put all of these "issues" into the complex
Being that sits in front of us. So, as I sit here wearing my white
coat, I can honestly tell you that nothing I've done over the last
two and a half years prepared me for my first patient. Not a thing.
Not even remotely. Of all the things I've learned, even over my
whole life, listening seems to be the most beneficial.
One of my biggest fears when starting clinic, besides being
worried I wouldn't know what to do, is that I would be stuck with
pure musculoskeletal cases. I know, this is chiropractic and
musculoskeletal would theoretically be a big part of most chiro's
practice, but I wanted the hard cases. And I'm getting them. From
complex vascular issues to hormone imbalances, I've had to do
research in the first week on topics that we didn't learn in any of
our classes. Before any physical exams, before any orthopedic
testing, just doing the history, I'm learning so much. I love
learning this way. Get a topic, find out as much as you can, and
then apply it.
Pick up a copy of Harrison's Internal Medicine, and
also a copy of the Textbook of Natural Medicine, and
Textbook of Functional Medicine. All three of these will
serve you very well. Even though these three are great resources,
there are some things that still require digging. I love a
challenge. Good thing I'm in the right field.
Have a great week everybody!