First day

Yesterday was my first day at my externship, and while it felt a bit slow, I think it's going to be a good experience, especially once I am allowed to start doing more.  Essentially, here's how things work.  There are three third year students (who are really for all intents and purposes fourth years now--this is their last rotation of the year) working in the clinic currently, several attendings, and me (and some residents in the afternoon, but we don't really work with them).  When patients' charts get brought back to be seen, one of the third years picks it up, enters any pertinent information, and goes and does an initial history and physical.  They write a note and present the patient to the attending (in the medical world, "present" basically means tell the doctor above you everything you found out about the patient, including what's going on with their current illness, any past medical problems, family history, etc., and also what you think might be wrong, and how you think you can treat it).  Then, the attending and third year combo return to the patient, the attending checks them out (it's two check-ups for the price of one!) and either oks what the third year said or adds to it if necessary.  

Now, I'm not a third year yet and, while I know the essentials of a head-to-toe physical exam and history, I haven't done many H&Ps on kids or babies.  So for the first couple of days, the head attending of the clinic basically decided to have me simply follow attendings around, and then I'll get to pick up some responsibility and act more like a third year doing my own thing.  Unfortunately, while I'm simply following folks around, the day can be a bit boring because the attendings don't usually see all that many patients without a third year doing it first.  As a result, I'm rather chomping at the bit for some real action.  I did at least learn how to differentiate between iron-deficiency anemia and thalassemia!

Despite the slower nature of the day yesterday, I did get to see some interesting stuff:

• 2 month old and 2 year old kids whose parents spoke no English, in for their check-ups and shots (saw these with a really nice doctor who actually let me enter info into the chart/note)
• 6 month old who was decidedly against my looking into any orifice of his body
• 8 year old with asthma who I got to listen to and do a pulmonary function test with
• Several well-baby visits
• a kid with a previous UTI

Things of note:  parents can be incredible in every sense of the word.  Like the parents who spoke no English, who clearly cared so much about their kids that they drove a pretty long way in order to see a doctor who spoke enough Spanish that they could understand properly how to take care of their child's anemia.  Or the overweight mother of the overweight toddler who explained that the only reason the kid was gaining weight was probably because he liked juice a lot, because otherwise he ate healthy (*smacks forehead*).  Fun times.