Saturday 21 September 2019

They need the training, but who'll be their guinea pig?

Student doctors learn through experience but it's not so nice when you're the day's lesson

Sheena Lambert

Over coffee with friends recently, the topic of student doctors came up; more specifically, being examined by student doctors in maternity hospitals. I was shocked that not everyone around the table was open to the idea of being examined by a doctor in training, or even having them present while being attended to by a fully qualified one. Isn't it obvious that the quality of care in hospitals depends on student doctors and nurses having some hands-on experience?

It's not as if it can be particularly easy for the student doctors either. There aren't many careers which require pre-qualification training on live subjects with genuine problems.

Pilots get a good run in flight simulators before they are allowed fly real people around.

Hairdressers train up using wigs, and when they do advance to real heads of hair, the person attached to it gets the service for free. And the hair always grow back.

Facing a person with a real health problem for the first time in front of your tutor and your peers must be incredibly stressful. We've all seen 'Scrubs'. The least I thought us patients could do is allow them to make their mistakes while someone with seniority (and a diploma) is there to rectify them.

However, as is wont to happen when one sits on one's high horse, my convictions were tested when my own GP subsequently recommended a precautionary mammogram for a suspected cyst.

Uncomfortable

The mammogram itself was surprisingly uncomfortable. My breasts may not have the pre-baby tone and perk they once had, but neither are they for moulding into the shape of a box of 20 ciggies, which is pretty much what was involved.

The radiologist was a young, attractive blonde, who remarked on my jeans and what a great cut they were.

"Topshop Baxters," I told her, suitably chuffed at anybody thinking that my thirty-six-year-old ass was worth commenting on.

(My sister later brought me down to earth as only sisters can by pointing out that she had most likely been trying to distract me from the procedure. God dammit. She was probably right.)

I returned to the hospital two weeks later for the results.

The consultant charged with talking me through them was a small, middle-aged Asian man, who spoke very fast.

Standing beside his desk were two scared-looking 20-year-olds.

Their eyes seemed to be pleading with me -- I glanced down to see if they were actually shackled to the desk, but no. It appeared as though they were there of their own free will.

"So these student doctors will be with us for your consult, okay?"

It was definitely more of a statement than a question, so I nodded and assumed the wide-eyed stare of my white-coated comrades.

At that point I assumed that they would be merely observing, listening to the consultant as he discussed my results with me, taking notes, watching my reaction.

But no. It soon became apparent that these guys were here to learn, that the consultant was here to teach and that I was the lab rat.

"You." He pointed at the girl. "Start."

Collecting herself admirably, the young would-be doctor asked me why I had attended my GP, why she had advised the mammogram, family history etc.

I decided to address her as I would any qualified doctor, so I answered her questions earnestly, respectfully, hoping she might get some confidence from being spoken to like a real doctor.

"Yes, yes, yes. You."

Finger shifted to the second white coat, a poor bloke who looked like he might keel over at any second. "What did she leave out?"

Cruel, I thought. Playing them off against each other. It was like an episode of 'Grey's Anatomy'. Maybe they would snog it out later.

"Er, ehm, er ... "

"HER CYCLE!"

The three of us jumped.

"She didn't ask about her cycle!"

Boy Student Doc looked at me, mortification in his eyes.

I felt sorry for him. How could he have known? Blokes are the ones who still think we measure our flow in grams.

Once we had established that there was no connection between my cycle and the discomfort in my chest, he looked relieved.

"Okay, okay. Well," the consultant turned to me. I thought he had forgotten I was there.

"Your results were clear, okay? Nothing to worry about."

He might have mentioned that to me a tad earlier.

"You do have a small cyst." Okay, I thought. No biggie. "I'd just like to complete the consult with a physical exam. Yes?"

Sure doc, I thought. You're the expert. Do your worst.

Of course, I had forgotten about my two new friends. Boy Student Doc was now the colour of his lab coat.

"You don't mind?" He gestured to them.

What could I say? These guys have to learn somehow. I couldn't falter now.

After the consultant did his thing, focussing on the area around the cyst, it was Girl Student Doc's turn.

Business-like, competent, she examined my breasts like she had done it a hundred times before. Which, of course, she probably had, being a girl herself.

Then it was Boy Student Doc's turn. I turned my head away and stared at the wall, partly to avoid eye contact and save his embarrassment, partly because he looked very like someone who was about to puke.

Whatever the urban myths about med school, it was clear that this guy had very little experience at any base.

What should have been like a firm massage was rather a gentle rub of cold clammy hands.

I tried to further his education by putting his hand over where the cyst was and pressing it down, until I suddenly felt like a creepy Mrs Robinson type, and dropped it again.

Ordeal over for both of us, the consultant nipped out to get a colleague from whom he wanted a second opinion on the cyst. He was gone nearly five minutes.

It's difficult to make small talk with two strangers when you're naked from the waist up and they are not. But at least Boy Student Doc had some colour back in his cheeks by then, and looked less likely to pass out.

The second consultant was a nice, bustling man. With an I've-seen-20-pairs-of-boobs-already-today-yours-are-just-another manner, he gave me a quick exam, checked my mammogram, and confirmed the cyst diagnosis. Lovely. Thank you all. I'm outta here.

"Just before you get dressed. . ."

Aw c'mon, I thought. Surely no one else needs to cop a feel of my 34Bs today?

"Can either of you tell me what this is?" He pointed to a dark mole-like spot under my right breast. Two shaking heads, and Boy Student Doc looked like he might puke again.

"Do you know?" He smiled at me. Buoyed up by the vote of confidence, I smiled back.

"It's the source of all my power" -- Chandler's line from an episode of 'Friends'. I'd always wanted to say it.

Four blank stares looked back at me. I lowered my eyes in shame. "It's an accessory nipple." I whispered it.

Could they not have come up with a less gross name for it? It's just a big freckle for goodness sake. It's not like I have three breasts.

And I'm in good company. Mark Wahlberg, Jo Whiley, even Lily Allen all have them.

But such facts didn't make me feel any less of a freak, sitting there, vulnerable in my nakedness.

"Top marks." The smiley doctor smiled at me and left the room, allowing me to cover up at last.

Boy Student Doctor looked at me with empathy, feeling my mortification. I'm guessing that's one diagnosis he won't forget in a hurry.

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