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human guinea pig: Humiliating myself for fun and profit.

Playing DoctorOh, no! I'm the first patient these 23 medical students have ever examined.

By Emily Yoffe
Posted Wednesday, July 4, 2007, at 8:33 AM ET

Emily Yoffe was online July 5 to chat with readers about this story. Read the transcript.

(Continued from page 1)

Sometimes it was hard for me not to laugh. Dr. A was so sweetly flustered that in a perfect Chaplinesque slapstick, he would drop his reflex hammer on the floor, bend to pick it up, and then discover that his pen had fallen out of his white coat. Dr. N wasted the first eight minutes of the exam trying repeatedly to get a blood pressure reading. The panic in his eyes seemed to say, "She appears to be alive, yet she has no vital signs." He finally solved the dilemma when he realized he was listening to my arm with the wrong side of the stethoscope. (My blood pressure readings, which require technical skills on the part of the doctor, varied from 87/60 to 125/90.) Sometimes it was hard for the student not to laugh. Shy and mousy Dr. B, after peering into my eyes and ears, said, "Now I have to look up your nose!" and let out an embarrassed snort.

From the moment petite, blond Dr. C came in the room, she took command. Before she started, she briefly told me what the exam consisted of, then explained each procedure before she did it. Her touch was confident, and she did all 45 parts of the exam without hesitation. She asked me to tell her if anything hurt or made me uncomfortable. After she listened to my abdomen and proclaimed, "Good bowel sounds," I felt gratified I was able to please her.

Dr. C made me wonder what it is that makes some people glide elegantly as swans, while others stumble awkwardly as mud hens. My main mud hen was Dr. I. He began poorly by asking me where the recording camera was, then addressed all his findings to it. For example, after I successfully stuck out my tongue, he said to the ceiling, "Patient's cranial nerve No. 12 is intact."

Like many of the students, Dr. I was baffled by how to assess my heart and lung function without breaching the fortress of my bra. Most students, while listening through the stethoscope to my back, simply worked around the bra. But Dr. I informed me he needed to unsnap it (no, he didn't use the one-handed technique). Then he stood in front of me, looked at my gown like a colonel contemplating an incursion, and struck. He peeled off the top of the gown, dropping it into my lap, slipped the bra off my shoulder, and left me hanging while he protractedly listened to my heart. (Dear Male Readers: Doctors don't strip their female patients.)

I sat there, as the tape ran, debating whether to stop the exam. Sure he had on a white jacket and was using a stethoscope, but in reality, Dr. I was no doctor, but just a pimple-faced kid who'd taken off my bra. My pondering was interrupted by an abrupt knock on the door. We looked over, and standing there was the real doctor in charge of the program.

"No breast exam!" she said firmly to Dr. I. He was left sputtering as she closed the door. I redid my bra and put on my gown. Dr. I gamely tried to continue, but he was so shaken he forgot to take my blood pressure, and before he could get to my reflexes, an announcement over the PA said the time was up. He had to put down his hammer like a contestant on Top Chef forced to drop the spatula before plating the side dish.

After every three exams, standardized patients take a break in a private lounge. There were about 20 of us divided into two groups. My group was undergoing the physicals, while a group of older SPs were pretending to have hurt themselves in a fall. Almost all my fellow patients were professional actors who supplement their income by appearing in a repertory circuit at the medical schools of Georgetown, George Washington, and the military's Uniformed Services University. I envied that some really got to exercise their acting chops. One told me she recently portrayed a depressed alcoholic with irritable bowel syndrome who wasn't even supposed to know she was depressed and alcoholic—the medical student was supposed to figure that out.

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Emily Yoffe is the author of What the Dog Did: Tales From a Formerly Reluctant Dog Owner. You can send your Human Guinea Pig suggestions or comments to .
Illustration by Robert Neubecker.
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Remarks from the Fray:

Just reading this column made my blood run cold and my nerves get all shaky.

Ugh. I hate having to go to doctors. I try to avoid the experience as much as possible. If I ever get a dread disease and then hear these wretched words from a doctor: "if only you had come in sooner it might have been possible to save you" I will know I have only myself to blame. I guess.

What makes this column so readable is how concerned and even nervous most of those doctors were toward Emily. I found that to be endearing in the sense that a patient is still a new experience for them and an experience that most of them seem to be in awe of, almost. It's heartening.

Many experienced doctors have a sort of tired, even annoyed attitude if you give them any "trouble" (ie: you don't lie there like a passive non-entity who does not ask questions that are too complicated while they examine you like a machine).

I think this attitude is changing. But managed care also imposes restrictions on doctors in terms of how much time they can spend with a patient and I think that impacts on how hurried and distracted a doctor may come across, as well.

--Mara5525

(To reply, click here.)

I worked as a phlebotomist at a teaching clinic, a health care clinic affiliated with a hospital where young doctors fresh out of med school do their residencies. There were about 20 residents, most between the ages of 20 and 27, and 5 supervising doctors, most of whom had been practicing for upwards of 25 years. Overall, working with the inexperienced doctors was a fantastic experience: they were cautious and methodical, careful not to miss anything, they were open to suggestions and willing to ask for help from their colleagues, and they didn't treat non-doctors like crap (which happens all too often in the caste system of the health care industry). Most of the residents made efforts to acquaint themselves personally with each patient, and often remembered the patient's name the next time he/she came in. I would highly recommend seeing a resident doctor, if only to help them learn or because it's significantly less expensive--it's a valuable experience for doctor and patient.

--teddygram85

(To reply, click here.)

This article nearly brought me to tears. As an overworked second-year resident only three or four years from the medical school experience described, it's pretty easy to forget that there are lay people, potential patients, actually out there rooting for me. In general I feel undervalued, underpaid, and looked on with undue suspicion at this point in my training. Thanks Ms. Yoffe, for reminding me that I'm here to do a good thing, and that sometimes people are pretty understanding of that!

--Kelton528

(To reply, click here.)

(7/5)

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