It sounds like a knock-knock joke, but from the other side of the door. Who’s there? When dealing with patients, the answer is often more unpredictable than you might expect. Charts don’t typically say, “Watch out! Naughty old lady with fast hands,” and it’s that element of surprise that can help keep med students and residents on the ball.
In our second episode, Faith interviews doctors Christopher Showers, Michael Coords, Daniel Maselli, Sabina Bera, and Christopher Carrubba about their first awkward patient encounters. (For more about Dr. Christopher Showers, click here.)
This is a transcript of the medical podcast, My First Cadaver — “Episode Two: My First Awkward Patient Encounter”:
MST AD: “My First Cadaver” is sponsored by Med School Tutors. Banded together from the cosmic reaches of the universe, here in this great company, are the most powerful forces of test prep ever assembled: Customized learning plans! Superlative tutors! Unmatched student support! Dedicated to the pursuit of obtaining and sharing knowledge for the betterment of your test scores and, ultimately, mankind. Let Med School Tutors be a part of your origin story. Together, we can save the world.
FAITH AERYN: This is “My First Cadaver” — true stories told by real med students, residents and MDs with warmth, honesty, and low doses of schadenfreude. I'm Faith Aeryn. When I think of doctors, I think of cool, calm, and collected beings with tremendous clinical intelligence and often (we hope) great compassion and humor. But just as we all must crawl before we can strut, med students must learn to negotiate trying, challenging and flat-out awkward situations in their clerkship and residency years before they can become walking, talking, confidently-practicing physicians. As a layperson with semi-chronic foot-in-mouth disease, I've wondered on occasion about just what types of uncomfortable situations doctors and med students are likely to find themselves. To scratch the tip of that iceberg, let’s time-travel back with Christopher Showers to his first patient interview as a very green first year med student who experienced, as he says, Romeo woes.
CHRISTOPHER SHOWERS: Ok, it was the first semester of medical school, and I come from a science background. My dad’s a geophysicist, I was chemistry. I had been cloistered in libraries and laboratories — I’m really excited I’m in medicine right? The first semester you don’t think you’re going to talk to patients, you probably shouldn’t talk to patients, Columbia has this thing Foundations of Clinical Medicine which stretches across the whole four years and Foundations 1 is first semester, you go to clinics. So…I don’t say anything. I wear a short white coat the attending physician at the clinic, really nice guy, Dr. Spears I remember him very clearly. He preps me he goes, “Ok, this is the patient, this is what they’re coming in with, this is what we know about ‘em.” I don’t understand half the words, like month two. He says, “Just be quite and sit in the corner.” So this happens for a couple of weeks and I’m lovin’ it I’m just going, “Wow! Medicine’s going to be great and I’ve got so much to learn.” Then I’m getting towards the end, fall’s coming on, we’re getting towards the winter term and he says, “Ya know, Chris, it seems like you get it. I’d like you to do this next patient.” It’s about halfway through our day, we’ve seen about two together and he goes, “Chris I want you to do this one, you can take it.” and I go, “Oh man…all right…all right… I can do this!” ya know? He clearly believes in me. So we prep, we go over the stuff. It’s a 20… I think..25…24 year old girl. I think I’m 24 at the time and I am so focused on her past medical history and doing this well right? So we get up and we walk out, you know I’m all professional. I know that I can do this I’ve got a lot of confidence. We walk in the room and this girl is just devastatingly beautiful…I mean just like…crushingly attractive. So I stumble over there and I kind of introduce myself and I mutter some stuff, it’s not even clear what I said but I remember the feeling and the feeling was, “Oh my gosh, don’t screw this up!” I think…I don’t remember the exact sequence of events, but I pull out my stethoscope, which is in my pocket, and I drop it and I fumble it and I think I introduced myself as Dr. Spears which is not me and then I have to go, ”No, no , no I’m the med student! I’m Chris!” and it doesn’t take a stretch of the imagination to extrapolate further how how awkward this whole thing was, right? I think about half way through Dr. Spears stepped in and just kind of took the reins back of the interview and actually got something clinical out of the encounter. I just kind of sulked over in the corner and tried not to make direct gaze with this beautiful girl. Dr. Spears was just utterly composed the whole time. I mean the guy didn’t bat an eye despite my total lack of composure. So then we walk out, we get what we need to get, he says, “Ok, we’re going to consult and we’ll come back in,” as is typical. I think we waited until we got into his office and he closes the door and then just busts out laughing. Like holding his side, has to take a seat in a chair that’s not his own, and he’s just like, “You should’ve seen your face!” You know, and I’m still mortified… I’m just dying and I’m trying to muster so much professional composure here and this beacon of medical intelligence is just totally dying laughing about how awkward I was with this beautiful girl. He was making fun of me. Anyways, we go back in, we deliver her some prescription I don’t recall. She very politely says thank you and kind of winks at me in this knowing… realizing her power over me. She leaves, I kind of wash it off, I go home and go “Oh, my gosh I really hope that… I think that’s just a humorous thing.” The next time I walk in, the registration nurse at the desk just kind of looks at me in this odd way and I go, ya know, “Hi Gloria, how are you?” and she’s batting her eyes and going, “Oh, hello Chris!” and giving me this very, very overtly romantic… and I’m going, ”Oh come on! This is not about last night is it?” Apparently, immediately after I left, Dr. Spears went to the entire clinic staff and just painted this picture of this incredibly bashful young boy who couldn’t… who stumbled over his tongue trying to say hello to a beautiful stage actress. I think I had four more weeks in that clinic and everyone just had a ball with it. I became this kind of like hopeless Romeo throughout the clinic. Every time I was going into a patient’s room, for probably a couple months after that, I just prayed that the patient in the room I walked into was not going to be a beautiful girl because I clearly demonstrated an utter inability to handle a beautiful girl at that stage in my development. It was mortifying in the best way.
DR. MICHAEL COORDS: This one might have to be edited out…
FA: That’s Dr. Michael Coords — a fourth year resident in radiology and a graduate of UMDNJ Medical School.
MC: You know you had to practice ObGyn exams in medical school and you had ObGyn standardized patients. So, we had someone who ran the clerkship who… she was very intense and everyone just hated the rotation and you learned a lot but she did a lot of things you really shouldn’t have to be doing. She hired a bunch of people from around the area to be standardized patients. Now we had different groups who were going and we’d broken into three different days and I was the last day. And people kept telling me how terrible it was, you know, it was so awkward, you’d get like 45 year old ladies weighing like 400 pounds and it was just disgusting and bad hygiene and you’d have to be doing these physical exams on them. It was all practice, they were all standardized patients, this is what they got paid to do. This wasn’t in a clinic scenario, this was before you dealt with real patients. So I’m like, “Oh crap, this is terrible.” Everyone is having the same stories about this is so awkward, this is like a low point of my life and so this was bad. And you’d have to do a breast exam, you’d have to do a Gyn exam. So I’m with a group of three of my friends and we’re going the last day and we’re like, “Oh man, this is going to be bad.” So we all walk in the door and some 22 year old stripper is sitting there, absolutely gorgeous and we’re like, “Wait! What… what… what just happened?” We all are getting red in the face like, “Are you kidding me? Are we in the right room?” She said, “Oh no, no come on in.” So she’s sitting there in her gown and we close the door and she takes her gown off and we’re looking at each other from different parts of the room like, “All right then!” So we’re doing that and I got yelled at because she’s showing me how to do the breast exam and all of that other stuff and I’m doing the breast exam… apparently I was taking my time way to much. Ahe was like, “Ok, you can…uh…move on to the next part now.” So that was little embarrassing because I was taking way too long feeling up her boobs. So… it was an interesting time and I learned a lot that day and I’ll never forget it.
FA: You met Dr. Daniel Maselli and his first cadaver in our first episode. Today, here’s one of his awkward patient encounters.
DR. DANIEL MASELLI: With my female medical student counterparts they might not have looked on this interactions as fondly but I never felt unsafe with this stuff, but when older ladies would hit on you or pinch your bottom or something I just loved those. I would crack up at that. Cause they’re so vivacious and you’re like, “You just pinched my bottom! There is no way that you’re sick anymore.” My favorite one, she was a lovely old Irish woman. I was on the hospital service and we were just finishing up some interviewing and she apologized because she said she usually looks much nicer than this and was just in some Betty Boop pajamas and apologized for that. I said, “Oh no, no, that’s ok. You look lovely.” And she said, “Why thank you.” Then I said, “I’ll see you in a couple hours when your results come back.” And she said, “Thank you.” and then went I went to go to leave she just gave it a little pinch it. I wasn’t too forceful. Ya know…just a friendly little… boop!
FA: Now, just as Daniel said, these kinds of situations aren’t always pleasant for women in the medical field. Let’s hear from Dr. Sabina Bera who recently graduated from Saint George’s University in Grenada.
DR. SABINA BERA: We were just on a normal medicine floor and there was this patient that we were examining and there was patient in the bed next to him and the patient in the bed next to him was looking at us and motioned for me to come over there and I was like, “Oh, maybe he needs something. Maybe he needs me to adjust his mask or whatever’s going on.” So I went over there and was like, “Can I help you sir? Is there anything I can help you with?” and he’s like, “Yes, can you please turn around and stand there.” And at first I was like, ”Wait… what is he asking me to do?” and then I realized, “Oh my god, this guy is hitting on me and is like snickering in the back.” I was upset. I was really livid. I was like, “You know what sir, we’re busy examining this other patient.” And then I just closed the curtain on him because that was pretty much the most professional thing I could do at that point. But… I mean that was sort of like an angry situation. But my favorite is whenever they’re like, if you walk into a patient room or something like that and you’re asking them questions and eventually they’re like, “Are you a Doctor?” and I’m like, “No, I’m a medical student.” Then they’re like, “You’re gonna be the hottest doctor one day!” I’m like, “Ya know, that’s actually what I was going for! So… thank you very much!”
FA: Speaking as a layperson, when I’ve encountered extremely attractive physicians in my own medical checkups, I usually have just blushed and clammed up. But as you’ll hear from Dr. Christopher Carrubba, a graduate of the University of Louisville, some patients will do the opposite and come on quite strongly.
DR. CHRISTOPHER CARRUBBA: First embarrassing patient encounter was something I kind of knew was going to happen early in residency. Just being a guy in OBGYN, I just kind of felt like coming in..this sets up some really awkward situations. So, young eager intern, ready to impress my attending. Ready to go in and kind of convince my patients that I knew what was going on, that I was a good doctor when, in truth, I’m a young intern that’s terrified out of his mind. Seeing some patients in clinic and I’m very dressed up, very professional. My nicest shirt, my nicest tie. Really going in and ya know, “Hey! This is Dr. Carrubba it’s nice to meet you. I’m going to be working with you today.” Just had a standard typical OBGYN visit where they were there for their yearly exam. Ya know, bi-manual exam, pap smear, breast exam, et cetera. I think right away I came in the room and knew it was going to be weird because the patient just started off and said, “Well if I knew my doctor was gonna look like you, I’d have spent a little bit more time getting ready today,” and kind of winked. Right away I felt kind of the hairs on my skin stick up a little bit. You had that little bit of cringe factor build up. I was kind of like, all right I’ll just steer this away. Ya know, “How are you? Nice to meet you. How’s everything going,” taking a history. There was definitely that creepy factor of, “Oh! Sit a little closer to me. Oh, you don’t have to mind, I don’t bite.” and then it really hit when she said, “Take your coat off. Get a little bit more comfortable for what you’re going to be doing today.” Never more in my life have I just wanted to walk out of a room. But you know, I soldiered on, we keep going. We finish the history and I say, “Ok, I’m going to step out. If you don’t mind, here’s the gown that you need to slip into,” et cetera, et cetera. And I come back and the patient’s just standing there completely naked. Not covered up with a gown, not at all and was kind of like, “Hey, I was having some problems. I figured you could help me.” Smartly, went out, got a nurse chaperone to come in. Things got rolling, I guess, again on the right track. Got ready to do the breast exam, talked the patient through it and right away when I first went to touch her I got a, “You have really nice hands. I’m really glad it’s you doing this today.” Completely uncomfortable! I mean, still just wanting to walk out of the room. We got through that and then it was time to move on to the bi-manual exam. Again, we go get everything started and the first comment she makes is, “Wow, you have really good hands! You’ve clearly done this a lot before! Do you have a girlfriend?” and that was the end of it. I finished up the exam as quickly as I could, rushed out of the room. Everyone was laughing because by then the nurse chaperon had kind of told everybody what was going on. The rest of the joke for the week was about my girlfriend from intern year.
FA: For the patient, a boop might be a way to take the edge off of a possibly dreaded encounter, or maybe it’s just their way of saying, “Hi!” in a non-socially-acceptable manner. For the med student though, it’s perhaps a test of their fortitude, self-confidence, compassion and wit. And isn’t it exciting not to know who’s waiting behind every door? It keeps us on our toes. Makes us sharper, better. Maybe even more interesting. It certainly gives us great stories. So, I’d like to raise a glass to not taking ourselves too seriously and remembering that we’re all human at the end of the day, even under those sexy white coats.
Thank you to Doctors Christopher Showers, Michael Coords, Daniel Maselli, Sabina Bera, and Christopher Carrubba.
The My First Cadaver Team
Papa Claire Music & Compulsion Music
Our Nerf-blasting friends at Salted Stone
And special thanks to Robert Meekins, who is not a doctor.
Stayed tuned for Episode 3: My First Patient Death, coming soon to a listening device near you.
And REMEMBER guys: During an avalanche warning, don’t go snowmobiling, or you could become someone’s first cadaver.
FA: I’m Faith Aeryn and you’re listening to my first cadaver…meh… My. First. Cadaver…. My first cadaver… My first…cadaver! No… that’s silly.
MST AD: This episode of “My First Cadaver” was sponsored by Med School Tutors. Banded together from remote galaxies are the most sinister tests of all time: the MCAT! COMLEX! SHELF! USMLE! Dedicated to a single objective: destroy the confidence of med students everywhere! Only one group dares to challenge this intergalactic threat: Med School Tutors! Let Med School Tutors be a part of your origin story. Together, we can save the world.