In my ongoing quest to bring the world helpful explanations about medical stuff, mostly the meaning of certain medical terms, I’ve been paying extra special attention to the different classifications of the common symptom of ‘Pain’. Here, for your education and my general catharsis, are excerpts from two memorable consultations I have had during my General Practice placement.
Me: Can you describe the pain?
Mrs Payne: Well, it’s a paining pain.
Me: So… is it like an ache, or a burn? Or maybe a stabbing pain?
Mrs Payne: No, it really is just a paining pain… You know, it just pains.
I know, it’s a paining pain.
Me: So, this pain in your legs, can you describe it for me?
Mrs Akers: Oh, it’s not a pain.
Me: Oh, I’m sorry, I thought you said you had a pain in your legs?
Mrs Akers: No, no, it’s not a pain, it’s an ache.
Definitely not a paining pain, then.
Today’s updated figures for today’s 31.9km GP pilgrimage:
Speed Zones, Outbound Journey: 50 – 70 – 60 – 100 – 90 – 60 – 90 – 80 – 40 – 90 – 100 – 60 – 80 – 50
‘Road Work’ Sites: 2
Workers Holding Signs: 4
Workers Working: 1
Kilometers Driven With Fuel Light Lit: 31.9
Rail Crossings Accidentally Crossed While Lights Flashing Red: 1
Boom Gates Destroyed: 0
Average Speed of Local Freight Train: 4kmh
Times My Car Hit By Train: 0
Trouble Thus Avoided: 8 (Please Rotate 90°)
Average Distance Between Speed Limit Changes: 2.28km
If you think I’m kidding, you’re wrong.
Final year of med school has just hit me. There is a subtle shift – knowledge and facts coalescing, light dawning. I still feel like I know nothing, but every so often I feel like I know what I’m doing and why I’m doing it.
Another subtle shift is underway on the hospital floor. Next year I could be a colleague. People ask where I’m applying, offer advice, discuss cases of interest like my thoughts could matter.
I decided about ten days back that I needed to stop avoiding the things that freak me out – practical procedures. And Whammo! No sooner had I decided this than a flurry of practical procedures came my way. Under supervision, I drained 2.4L of fluid from an elderly lady’s chest (“I can breathe again!”), and did not generate a pneumothorax. I sutured (extremely badly). I backslabbed a man’s fractured wrist and completely failed to get a cannula into a vein for a man who desperately needed one. Two in fact.
Today I assessed a patient in ED, summarised my findings, proposed a diagnosis, recommended therapy, and discharged them home with scripts and instructions.
I second-guess myself.
“What if it was amyloidosis?”
“What if I sutured his skin all wrong?”
“What if he’d got fluids earlier?”
“What if I introduced an infection?”
What if I never made a mistake and never learned anything?