Fart Noises and Gobbling Like a Turkey

Look to the left. This is what I’ve learned to do this past week: make little children giggle. The first patient I saw by myself saw me walk into the room, and ran screaming into his mother's arms. He was not happy at all to see me (I think it was the stethoscope and tie), but fortunately with a few high fives and a chance to let him look into my big ears to see if he could find my brain, he did let me listen to his heart and lungs. After this near disaster, I felt I needed to come up with a few new techniques to gain the trust of my little ones. The first technique I stumbled upon completely by accident. My second case was a two year old girl with MRSA. I had to put on gloves to examine her abscess, but there were only mediums in the room. So during my struggle to get the first too-small glove over my hand, I blew into it to help maneuver my hand into the individual fingers. I looked down, and my little two year old was beaming. Of course, there was only one possible course of action. I blew up the other glove all the way, held it on top of my head, and gobbled like a turkey. When I released the air, it made a fart noise and blew around the room. It was an instant hit with her and Grandma, both. "Dr. Robby likes to play!" Not a doctor yet, Grammy.

There are other things I learned this week. I now know how to make airplanes and helicopters out of tongue depressors. I can push a child's "starter button" (navel) to turn her on and off. I can look through a little boy's ear and see out the other side. I can turn an otoscope on and off simply by snapping my fingers, and I'm even working on my bird calls just in case I find any species of the avian variety flying around inside a four year old's eardrum.

On the other hand, I haven't learned much medicine. In fact, it was frustrating to realize how much I don't know, and need to know. I seemed to have found the one place in America where all the metabolic syndromes and hereditary disorders we learned in Molecules to Cells were discovered. I saw two babies with "floppy baby syndrome," a newborn with a heredity immunodeficiency disorder, a woman with tuberous sclerosis, and a patient who came in with pyruvate carboxylase deficiency which only occurs in 1 in 250,000 births worldwide! I realized that I learned much more than I thought in the first couple months, but I wish I had studied harder. It would have been nice to remember some of the details of these disorders that seemed so mundane and dry in class, but came to life (literally) here in Boone. My preceptor commiserated with my frustration, adding that it will all come with time and experience. I did get lucky with a phenomenal proctor. We spent from 8 AM to 7 or 8 PM in the clinic everyday, with patients waiting for hours and hours. But no one seemed to complain. They all came a long way to see my doctor specifically, and every patient and family member left with a smile (unless they left immediately after their immunizations; then you could hear them leave...).

I have also been surprised to discover I have picked up a significant Southern drawl when talking to patients. At least 90% of the people in the clinic have strong Western North Carolina/Appalachian accents, and quite of few of them are on Medicaid. As the conversations develop, my neutral half DC, half NC accent loses the DC part. Words become longer, and I don't think I've ever used "y'all" so many times in my entire life. I promised myself in high school that I would never succumb to using that ridiculous non-word, but Shelley will be proud of me. I guess that's what I get for living in the South for the past five years. Hey, I'd combine a few more words if I could stay away from city traffic for another few years.

Other tips and observations:

1. Get your kids vaccinated. It's not cool when you come to the office with meningitis. Vaccines are safe. There is no evidence they cause autism. None.

2. Use the European method of potty training. Look it up. The American way is crap (or at least you'll get more of it in diapers and less of it in the actual toilet).

3. Clear lung sounds with a nasty cough and fever means the flu. If I hear crackles in the backles, it’s something else. Don't ask me what though.

4. Nobody under thirteen years old actually likes shots, so let them get the flu-mist. It's better and they won't hate you for at least a day.

5. New mothers and fathers who write down their questions in a little book ahead of time are adorable.

Anyways, back to the classroom on Monday, but at least it's Anatomy. Time to cut. First though I'm heading down to Troutman, NC to spend a day or two on the lake with Brandon and some med school peeps.