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| This is where the Family Medicine faculty work |
Since Dr. Cathy Bryant, my overseer of this program, is a Family Medicine physician, I was able to have many observatory experiences shadowing in the area of Family Medicine.From birth to near death, these doctors' must be able to understand and treat (to the best of their ability) the medical problems their patients have. So from birth to death, here is my summary of my experiences.
Birth: I got to see a woman give birth. Before this experience I did not know that Family Medicine physicians were able to do obstetrics which is pretty cool. This was also the first live birth I had ever see so it was more special for me. I was ready for anything--the screaming, yelling, cussing out of the husband, execution of the breathing exercises etc. I got NOTHING. No, not nothing, I saw this woman watching TV then once she delivered her baby she went back watching TV. And I got to see the baby with the umbilical cord around its body and how the doctors maneuvered so that the baby was able to safely come out of the womb, I even got to see roughly a gallon of "water" come out after the woman gave birth because how the baby was positioned, its (actually his) head stopped the "water" from leaving the womb even though it was already broken; but nothing like I thought it would be. I was even wondering if the media exaggerated what happens in the delivery room when the doctor I was shadowing that day Dr. Mengichi, told me that this was her fourth child so there weren't any surprises for her. That really explained a lot and I'm now back to not rushing into getting pregnant and having babies anytime soon (yah me). Also, St.Vincent's obstetric department practices the use of epideral analgesia in order to promote a calming environment for the mother during labor. From what I saw today, it definitely helps.
Children: When shadowing all the doctors I was able to see them with child patients. Around this time, there was flu going around so alot of children were going around with flu-like symptoms. However, I didn't just see children with flus, there was one funny case of a seven-year-old who was afraid that she was "developing too early" and also had swollen lymph nodes on her neck. The doctors had to assure that she was fine both in health and development. I also saw a case where the family didn't bring their child in for the immunization shots in a timely manner ( they were 18 months behind) and the doctor I was with had to stand in as an advocate for the child and call Social Services in order to help the family get back on the right track.
Young Adults/Adults: Nothing too interesting. The appointments ranged from chronic headaches, check-ups, Pap-Smears (FYI: I've observed enough Pap smear procedures to never want one), etc. However there were two interesting cases in this age group. One case involved a young married lady who was battling depression as well as bronchitis. It was eye-opening how Dr. Bryant was working not only with the patient but also with her psychiatrist to help this woman. What was even more interesting is that with all the progress that this woman made, she came to ask Dr. Bryant if she could temporarily stop taking the pills because she was going on a cruise and (if it happened that she had a couple of drinks) she didn't want any detrimental side effects to occur. lol. I'm not judging her but it's funny, people will be people and people will always try to compromise something they need for something they want. Something to remember in the future as a physician. Another case, involved another lady who was nearing menopause and was not happy about it at all (along with other things). This woman had unfortunately suffered a work related injury as a registered nurse and was on disability. Because of this, she dealt with mental stress and as a result gained weight. What was so funny about this patient is the fact that she boldly told the doctor everything and how she knew that she did not follow the doctor's orders to the point that it was comical. While having her Pap Smear she asked if there were bats "down there" because her kids were jokingly telling her that since she hadn't been with her husband for a while and getting old that bats were probably inhabiting her "cave" now (no lie). The doctor was able to ensure her that she didn't have any bats in her cave. As you probably guessed, I left that patient's room in a pleasant mood.It's funny, even though as doctors you're suppose to be the one to make patients feel better, if laughter is truly medicine, then I don't know who was doctor and the patient after that because both I and the doctor felt better. However, I'm sure the paycheck helps distinguish between doctors and patients :).
Elderly: Dealing with the elderly is interesting because that population is like being both a pediatrician and a family practice doctor all at once. I don't say this to insult these patients at all, however as you may have noticed from the House Call post (if you have been reading, which you should have been) but this population is interesting in that there is an expectation to take the proper medication as well as take care of themselves, however sometimes either due to forgetfulness, lack of desire, budding children in denial of their parent's age and health problems, etc. sometimes the expected results and improvements of health for these patients is well, missing. So as with the house call, I saw that the physicians have to figure out the missing pieces of the patient's story in order to figure out both whether the patient is being honest, and what factors may be affecting the patient being compliant. For me it's interesting because although as a doctor you'd want to take care of these patients, these same patients want to be able to take care of themselves, independent of doctors orders, and really I don't blame them.
Well this page is getting too long so I'll end it with this: Family Medicine physicians are the "jack of all trades, master of none" field of medicine. Which, when it comes to providing primary care to a population that has medical issues from allergies to asthma to arthritis ( you like how I used "a's" to show the age gaps?), meaning, helpful to all and master of none is really what these patients need.
