Sir, I Hear You've Been Peeing Yourself

So perhaps I should've taken this Step 2 Clinical Skills exam more seriously (or sooner). Kelly, Matt, and I took an insane road trip down to Atlanta for the test, with the excursion culminating in our car breaking down in a not-so-nice part of town. The exam itself was a bit of fiasco as well. It's 10-12 patient encounters, a 15-minute exam, follow by 10 minutes to write a patient note (down to the differential diagnosis and lab tests). Needless to say it has been a while since I've seen a patient (family doesn't count, does it?). And also needless to say, we didn't practice very much on the drive down. We were partial to debating the merits of ASAP Rocky and how evolution has "shaped" the male penis.

Now, the United States Medical Licensing Exam (USLME) people say I cannot discuss the contents of the exam, so I won't (I will change my case so no one can tell! Ha. But seriously, the case is different; my words are not). But everyone knows that there are a variety of medical cases that students may see. Each patient presents a different problem. As the exam went along, I got much better. I started getting back into the groove, remembering which questions to ask and when. However, I got off to a rocky start. My first encounter, well, it didn't go so well. See, there was this man that I suspected had benign prostatic hypertrophy... aka a big prostate.

Good morning, Mr. Smith. My name is Dr. Swendiman. How you doing today?
Well, not so good doc.

I'm sorry to hear that. Tell me what is going on. I hear you are going to the bathroom more frequently?
Well, for the past few years, I have had trouble holding my bladder.

Tell me more about that. (Such a great question! Open ended and everything. Great job, doc.)
I seem to be going a lot. Many times a day and then a few times at night. It's got me very worried.

Well let's see if we can't figured out what's going on.

I was doing great up to this point. I made eye contact (check), shook hands (check), introduced myself (check), stated the patient's name (check), showed empathy (check). Then I realized that I knew zero medicine. None. I was already out of questions and I only had asked two. Over the past nine months, my clinical skills have deteriorated into simply a gorgeous, breathtaking smile.

So, you say that you have been urinating more frequently?
Yes, sir.

Okay, so you've had to go to the bathroom much more often then?
Uhh, yes. That's what I said.

Ummm, so your trips to to the bathroom have become more frequent in nature?
YES! YOU FREAKING DUMBASS.

(He didn't say "dumbass," but I could see it in his eyes...)

Uh okay, well, um, Mr. Smith, to get a better picture of what's going on, I'm going to ask you a few questions about your medical history. Do you take any medications...

Annnnnd I fell flat on my face. I wish I could say this is an exaggeration. I wish I could. I moved on to the past medical history, meds, allergies, surgeries, and social/sexual history. The whole time I was collecting this information, I was thinking of follow-up questions. Eventually I remembered my OPQRST, review of systems, and made a differential (yes, I remembered to worry about prostate cancer too). But it was a rough start. Step 2 CS is pass/fail, so daggum, I hope I passed. April 17th is judgment day...

Note to self: no more taking a years off. I went home a promptly bought a series of medical review books.