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October 24, 2005
Mr Lake
My first patient. My first standardized patient. My first standardized, scripted, done-this-chest-pain-script-so-many-times-he-can-improv, patient. Sweet. There's three of us students. Sure, I'll go first.
Hello, Mr Lake? [Mr Lake has his back to me... I'll walk around!]
Hello, Mr Lake? I'm Niels Olson, a medical student at Tulane. Do you mind if I ask you a few questions? [Do I ask if I can have a seat? Does my doctor ask that? It's not his hospital... Look at that, I'm sitting!]
So, what seems to be bothering you?
And how often do you have this chest pain?
It feels like pressure... And does it radiate? From you back to your stomach... [Why does he have an insulin pump? Is that part of the bit? Man, wouldn't that kind of complicate chest pain? We haven't even cracked the chest on the cadaver. It must not be part of the shtick, ignore the insulin pump.]
[Ignore the insulin pump]
[IGNORE THE INSULIN PUMP! THAT ONE! RIGHT THERE! THAT LOOKS LIKE MY OLD CELL PHONE! IGNORE IT!]
And how long does the pain last? Thirty or forty seconds, great. [It's not great! What the hell was that?! Great....]
You seem tense. [Note the lack of follow-up here...]
So, do you have any past hospitalizations? [My classmates are sitting there, so safe. I want to sit over there, watching the fool trying to interview the standardized patient...]
Blah
Blah
Blah
Okay, well that about raps it up, thanks for your time Mr Lake. I'll go brief your attending and we'll see what we can do to help.
———Next student———
Blah, blah, blah
Other student: "You seem tense. Would you like to talk about that? Is something troubling you, Mr Lake?"
Mr Lake: "Yes, yes, the stress is killing me! We just moved into this house, our dream house, that we built, and one night two weeks ago a thief came out of the bushes and beat me over the back and stole my wife's purse! And the economy's in a downturn and I've had to lay people off at my architectural firm, and my 18-year-old daughter stays out late, and I've got these skin cancers on my hands, ohhh, it's so horrible! I don't know what I'm going to do! I can't even sleep in my own home!"
[Hmmmmm..... should've followed up on that tense thing....]
Posted by Niels Olson at October 24, 2005 6:23 PM
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