One of the selling points medical schools are using these days is early “patient encounters.” My school is no exception. On the first day of class we did a thought experiment where our professor stood in the front and talked about a patient he had in the past. We sat there, mind you with no medical knowledge, fumbling around with questions we should ask the patient. As an educational tool, it was marginal at best; as a tool to humble us, it is second to none. They preached to us (a class of 150) that this was “our first patient.” However, I consider my first a man that came a few months later.
In our curriculum, we spend a multitude of days in the hospital or other healthcare settings. For instance, I have had the opportunity to spend time in the Labor and Delivery department of the local hospital (and got to see a vaginal birth!), as well as oncology, ultrasound, hospice, and the neonatal intensive care unit to name a few. These experiences will have to wait because my most influential moment so far has come on House Calls.
Many think that House Calls are a thing of the past. My mother has told me plenty of stories of the doctor coming to her house with his little “black bag” of medical toys and menageries to check on the “sniffles.” House calls are even highlighted in Michael Moore’s idealistic protest for universal healthcare documentary, “Sicko”. He even shows how Paris has a doctor that goes around in a swanky little car to check on a stomach ache. Daringly, he even asks why in a great nation like the USA, can we not have house calls? Well, Mr. Moore, we do.
It was a warm late summer afternoon, I had already had a long day at school full of lectures and other exhausting activities. I was despising that I was going to have to spend the rest of the afternoon traveling around the city dressed up and in my white coat (for which everyone seems to wear EXCEPT doctors these days). I reluctantly went with my partner to the headquarters to figure out which house we were going to meet our doctor preceptor at. The receptionist printed off a google map image with directions for the first house.
House calls – at least at the hospital I work at – are reserved for patients that have difficulty, monetary or physical, making it to the main campus or one of the countless clinics that seem to be at every corner of the city. A doctor is sent to the house where a full examination can be done including such pedestrian objects that litter most houses.
Meeting Dr. Smith at the patients house, she sits me and my partner down as explains the patient to us. “This is an 86 y/o male, who is suffering from dementia, weight loss, and had a stroke a few years ago”. What she did not tell us was that this man has lost the ability to talk, hear for the most part, see, and even move. I was not prepared when I was taken into the room to find Mr. Jones who was barely alive. For the sake of full disclosure, the cadaver that I am learning anatomy from appeared to have more life than this man. Looking around the walls I can see pictures from when he was younger, a prominent male in the community of considerable size and presence. Now, he is a lifeless corpse with the ability to moan being his only form of communication left – and this ability is transient at best.
Dr. Smith with her desire to teach us, unleashed us with a stethoscope and a sphygmomanometer (blood pressure cuff) both of which we learned how to use a week before, and told us to do a complete physical. I took his pulse, blood pressure, and temperature; as well, as listening (or auscultation) to the lungs and heart. As we fumble through the procedures Dr. Smith is quizzing me – to which I answered maybe 1 or 2 questions correctly. The entire time, Mrs. Jones is watching. To say the least, I was thoroughly embarrassed. I can only imagine the amount of pain that Mr. Jones was in, not to mention the “torture” he was put through, all in the name of education.
I felt like Siddhārtha Guatama, stepping outside of the kingdom for the first time and learning what pain and suffering means. Although, I do not think that I am on my path to becoming Buddha, Mr. Jones showed me how little I know – a powerful lesson, especially from a man who cannot speak, hear, see, or move. For this, I am eternally grateful. Thank you Mr. Jones, you truly were my first patient.
