Oh, no! I'm the first patient these 23 medical students have ever examined.
Emily Yoffe was online July 5 to chat with readers about this story. Read the transcript.
Over the course of three days recently, I had 23 head-to-toe physicals from 23 second-year students at the Georgetown School of Medicine. I was the first person these would-be doctors had ever fully examined on their own. Some were shaking so violently when they approached me with their otoscopes—the pointed device for looking in the ear—that I feared an imminent lobotomy. Some were certain about the location of my organs, but were stymied by the mechanics of my hospital gown and drape. And a few were so polished and confident that they could be dropped midseason into Grey's Anatomy.
Georgetown allowed me to be a "standardized patient"—that is, a trained person who is paid $15 an hour to be poked and prodded by inexperienced fingers, so that med students can learn communication and examination skills before they are sicced on actual sick people. In Human Guinea Pig, I try things you might want to do but don't have the time or opportunity. However, even if you had the time or opportunity, you probably wouldn't want to be examined by 23 medical students.
The concept of the standardized patient has been around for decades, but only in recent years have medical schools made training with them a regular part of their curriculum. I talked to a 50-ish physician friend about my experiences, and he said when he was in medical school and it was time for the first rectal/genital exam, the students were told to pair off and examine each other. "So, do you pick someone you like, or someone you don't like?" he recalled. "Either way, it's lose-lose."
Now there are standardized patients trained for genital duty (they're called GUTAs, for genitourinary teaching associates), but I signed up for something less invasive. Mine was the simplest possible assignment. I was to sit on the edge of a padded table in one of those awful, flapping hospital gowns, in a room equipped with recording devices in the ceiling. Each doctor had 30 minutes to conduct a standard head-to-toe physical: from my vital signs, to my nerve function, to my reflexes, etc. Then I was to go to a computer and check off whether they'd done all 45 parts of the exam ("Palpated for fremitus," "Auscultated carotids"), and write my comments on their bedside manner.
There are some obvious things you hope no doctor ever says to you, but on this assignment, I discovered there are a few others:
"I have to admit I have some butterflies."
"I've never felt anyone's liver."
"I'm so sorry! Are you all right?"
I actually was charmed by the students who acknowledged their nervousness, and it was adorable the way most of them would stop after finishing one body part, look upward as if at a floating textbook, mumble some mnemonics, then continue the exam. Before he left the room, Dr. K (although they can't yet call themselves "doctor," I'll call them that here; they're so eager, they deserve it) ran his eyes over me and said, "Let me check if I forgot any major systems. That would be bad." But nervousness in a doctor can be dangerous. Dr. F had a relationship with her instruments that reminded me of Edward Scissorhands. She apologized profusely after stabbing me with the otoscope.