Thursday, April 1, 2010

Oh, med students . . .

I saw my rheumatologist yesterday. Good visit. We checked-out my mini-flare, my joints, and a quick physical exam. To help my through the final stages of my Prednisone reduction I will be enlisting the help of an old friend - Naproxen. The appointment went well - except for that pesky med student. To be fair - he is a doctor of Internal Medicine going for extra training in Immunology. So not a super green 3rd year med student - but still seemed just as green and clinical.

Now don't get me wrong - I always agree to have med students watch procedures, perform procedures, take my blood, interview me, perform joint injections - the whole nine yards. This time, however, it was beyond awkward - he just didn't get RA. Here are a few excerpts from our conversation.

Med Student: Are you sure you're flaring? Because I can't find any inflammation...
Me: Um, yes - I am flaring and there is inflammation in the following joints...

Nice. I've had RA for 19 years, but - according to him - perchance I can't recognize a flare when I see one. Perchance he can't recognize a joint if he sees one.

MS: I see you are on Enbrel. Well, Enbrel is a biologic that -
Me: (smoothly cutting him off) I'm a fairly well education patient and I've been on Enbrel for 10 months. I know what it does.

Seriously? Did he honestly think that I would take a medication, any medication, that I didn't know what it did? For 10 months?

MS: I don't see why we don't raise your Prednisone back up to 2 mg
Me: I just explained that I've worked for the past 10 months to get off of it - I'd rather look at NSAIDs as an alternative. I don't want to be on Prednisone anymore.
MS: It's not that much Prednisone.
Me: For whom?

The Med Student seemed like a nice guy, he just treated me like a number and was quite clinical about the whole thing. A + B = Flare. Not matter what the patient actually says.

He hadn't reviewed my file (I know, because I asked in one exasperated moment) - not even the last letter to my GP updated on my current status. Sigh. I usually have a good amount of patience for this kind of thing, but I couldn't help feel that he was wasting my time. I knew a 5 minute conversation with Dr. T (my rheumatologist) would solve everything - and quickly. And in the end it did. Whew, that was as exhausting to write about as it was to experience it.


Laurie Grassi said...

Fail! OK, maybe I'm being harsh, but, good lord, read the file, don't treat people like idiots, and, well, I'm tired and I'll stop now. Good luck with the Naproxen and Happy Easter! :) Laurie

Leslie said...

great...another future doc who doesn't treat patients as people...just what we all need :(

Anonymous said...

Hopefully this med student's experience with you will give him a personal jolt in the right direction, and he'll learn a lesson about being more careful not to assume things or walk into an exam unprepared. In his defense, he probably deals with many people, day in and day out, who are not nearly as experienced with or educated about their conditions as you are, so it's good that he met you so he won't assume all his patients are the same.

Glad your regular doc was around to cut to the chase. Here's wishing you the best of luck as you wean off prednisone and move on in the ongoing fight against your RA. Have a lovely holiday weekend.


Anonymous said...

Oh the drudgery of it all yes? I too am more then welcome to allow students in my room especially since according to my doctor I'm a very complicated case. What better way to rule out the "real" doctors from the crowd eh? Give them a tough broad with a tough disease or (s) in my case. Most of us are MORE educated than students or even 2 and 3 year med termers. We are learning specifics of ONE disease where as they take in a few minutes of many. Good for you knowing what you do and don't want. Gentle hugs. Tammy