Went to the office today, the same preceptor who wasn't there last Monday. He was there, a medium-height man in Gucci frames that look like they should be held together with masking tape. He moves with purpose, quickly, but when it is necessary, he takes his time. It is necessary with some patients. I got one of them. Every response I gave prompted another question. It began with a simple one - "Tell me," he says, "what are the symptoms of hypertension?" I explain that the most common symptoms are "none". Then he asks about the insurance company and his EKG and his echo and why they want to rate him and what's wrong. And then what about heart problems? And what about this, and what about that, and "I eat half a grapefruit every morning, is it okay to take Lipitor?", and then he wrapped up with "How would I feel if my potassium were low?"
I came out feeling drained. I told my preceptor I'd just been pimped by a patient. He laughed. "Nykki tells me," he says to the patient, "you worked her over."
"She did a good job. Answered my questions." He smiles. "She's a sharp one."
I'll pay you later, my preceptor says. On the way out, the patient claps his hand onto my shoulder, and in a quiet and emphatic voice says "That's what I want a doctor's appointment to be like. I learned something. You stay this way."
Two compliments today. The second came from a couple he sent me in to see after warning me that the wife was "a character." They didn't press me hard, but they did press me with a number of questions. And they wanted me to explain things. And I did, I answered all the questions they asked. And when my preceptor came in, the wife grins at him. "She's a keeper. She does a great job."
We had lunch with the drug reps. They want us to go to dinner next Monday night at Chappell's, for some drug rep talk. Might be fun, I'll have to ask my preceptor if he plans on going. If I remember.
Patient who probably has lupus, who might have thyroid dysfunction, or might not and it was just the other problems making her look like she had thyroid dysfunction. But she definitely has hereditary angioedema secondary to C1 esterase deficiency. She's not that old, and the prednisone is puffing her up huge. We treat C1 esterase deficiency with anabolic steroids, more or less. She cried when we mentioned that. We'll let the rheumatologist do the dirty work.
It was a good day, an interesting day. Dr. G treats me like a third-year student and well. I like him. It is a good month, O Best Beloved. A very good month.