Adventures in Sigmoidoscopy

So, let me first start off by apologizing for being away for a week. I honestly had no idea that my blog became such a key part of people's everyday procrastination. I was thinking of making it up to you by giving you like 2 posts at once, but then I realized that if I made them 2 separate posts on different days, that will give you twice the procrastination (I dont' know if that made sense when I explained it, but it certainly did in my head). Plus I realized I actually have to study occassionally.

Just to update you, I have been working for the last 2 weeks with a gastroenterologist (digestive system doctor) at his private practice. He is a real nice guy and is ALL about the teaching. In fact, there have been numerous times where he has handed patients several week-old People magazines (currently the ones featuring the late Anna Nicole Smith when she had her baby and Jessica Simpson when she started dating John Mayer, which I think is hilarous that he recommends these) and left the patients in the room for like 15 minutes at a time so he can show me other patient's charts who are not even alive! Also, I feel I should mention he is a small Filipino man who laughs like Pai Mei from Kill Bill Vol.2 (if you have yet to see this movie, do yourself a favor and rent it NOW).

Anyways, being a GI doc (abbreviation for gastroenterologist), my doc performs all kinds of colonoscopies (up the butt), endoscopies (down the mouth), and flexible sigmoidoscopies (like a colonoscopy but can be done in the office). So the other day we had a patient come in who need a flex sig; however, she had no insurance and was low income so it was designated a "charity case" to be done free of charge. Evidently, "charity case" is equivalent in my doctor's mind to "great teaching opportunity with high potential for disaster but low potential for a lawsuit." Thus about 30 seconds before the patient walks in the door my doctor told me that I would be doing this whole flex sig MYSELF.

Okay, lets just stop a moment and see what this really entails. I, a third year med student (NOT a certified doctor), will be placing about 2 feet of 1 inch diameter electronic tubing up a complete strangers ass unassisted while the patient is completely conscious. Obviously, only good can come of this situaton. And best of all, we are apparently not going to inform the patient of this fact until after we have started.

Well, once we have the patient facing the wall (so she can convienently not see who is actually doing the work), I lube up the flex sig and was instructed to "go for it." It is pretty much a video game with little knobs that let you see in all directions, but instead of being Link looking for the triforce in the Legend of Zelda, you are a medical student looking for a crazy mass in a colon -- same diff. For the first five minutes I blindly fed this tubing into this patient's lower GI tract pretending to know what I was doing all the while talking confidently like I have done this a million times. I should mention that I have become unbelieveably good at convincing patient's into trusting me even though I am the LAST person they should.

Suddenly, as I made a corner with a turn of the knob, everything came into view like one of those Magic Eye posters where you stare at it forever and finally see that damn rocketship. I was then able to guide the flex sig down to the transverse colon with the accuracy and speed of one of Legolas's arrows into an orc (come on, when you saw that in LOTR, you tell me you didn't want to take up archery....or am I alone on this one?). I must say I was quite proud of myself because 1) I did it and 2) my patient did not scream in horrible pain (always a good thing when practicing the art of medicine).

Anyways, my doctor was thoroughly impressed with my work -- seriously, he went on about if for the rest of the day. I think he thinks I have a real gift while meanwhile it was a whole crap load of luck. In fact, I got a pretty "delicious" reward for my good work....but we will leave that interesting adventure until the next blog (hopefully tomorrow).

So, class what did we learn today.....
1. When a doctor leaves you in the room in your underwear because "he has another patient to see" or "has some results to check out" be highly suspect -- most likely it has nothing to do with that and he is exploiting your ignorance.
2. When getting a procedure peformed, ask EVERY question you can think of and take NOTHING for granted, even the doctor doing the procedure (oh, there have been times when I was in surgery and the "surgeon" was not even in the room for the procedure!).
3. When you see a medical student in the room, be afraid, be very very afraid because at that point you turn from "patient" to "test dummy A."
4. While medical students wear the white coat and know the lingo, they are in fact NOT doctors -- remember that fact especially when they come near you with something that may look uncomfortable if it was jabbed in an oriface.