Wednesday, 11 May 2011

My First Clinical Exam or The Day I Became a Man.

Let's go back. Back to a time when I was just a young naive student, eager to learn, hopeful about my future and just ecstatic about choosing medicine as a viable career option.

It was the day of my first clinical exam. Now let me just offer a quick explanation on what a clinical exam entails. It's a test (that you're graded on) that includes you, the patient and the doctor grading your performance with the patient. Bear in mind that the doctor doesn't care about how difficult the patient is, or how nice you might be. All the doctor wants is proper examination skills and a diagnosis plus or minus a management plan.

Oh, and you have to wear a suit. With a tie. Not a white lab coat. A suit. In the summer. With a tie. While examining a patient. Something about respecting the fact that the senior professor actually had to get off his or her ass and grace you with his/her presence (I was never too sure about the details).

Anyways back to the exam. There I was, nervous, anxious and ready to go. The patient was an elderly woman who looked like my grandmother (sweet and adorable old, not gray and senile old). I took it as a sign and went straight to work.

"Hello, my name is Dr. A. What's your name?"
"Zaynab, but you can call me Sayyeda Zaynab." (Sayyeda Zaynab is a district here in Cairo hence the humor)
"Ah. Ha-Ha. Okay well what brought you to the hospital Mrs. Zaynab."
"Right, sorry. Sayyeda Zaynab."
"Well, I've had this cough for a while and I decided to finally go and have it checked."

After I took the history it was time for the ............................examination... (You'll understand my hesitation to continue with this story in a bit, I promise)

I got the stethescope out and decided to auscultate her chest. Now she was wearing a gown so I tried to get the stethescope through but I failed. So I asked her .....nicely......... to unbutton her gown a bit. (We're almost there. God no. Please don't let me relive this again.)

"Why should I unbutton? Here, let make this much easier for you Doc."


Took off her clothes.
She was 73.
She wasn't wearing a bra.
She was 73.
You know what happens when you're a woman and you're 73.

You Sag.
Like touch the floor sag.

(Excuse me while I go puke again)

I was 20 years old! My eyes lost their virginity. I was like a deer, caught in the headlights of a speeding car. I wanted to look away. I swear! But I couldn't. Apparently I stared for a while in silence because the doctor decided to interject.

"Well, aren't you going to palpate?"
"Excuse me? Palpate?"
"Yes! Palpate the chest!"
"Um. With my bare hands?"
"Yes! You've got to palpate supra mammary, infra mammary AND mammary!"

To this day I do not remember what happened. I get visions sometimes, late at night when i'm asleep. They wake me up. I'm getting better though so help me God. I remember how it ended though. Sadly my brain decided to leave me that memory.

I remember her wearing the gown again. I remember the doctor telling me to leave. But right before I left, Sayyeda Zaynab grabbed me by the arm, winked at me and said

"You've got great hands Doc."

I'm not a dirty whore. I'm not a dirty whore. I'm not a dirty whore. I'm not a dirty whore.I'm not a dirty whore. I'm not a dirty whore.

That was and is my mantra every single time I shower.

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