Bodies

tag:blogger.com,1999:blog-5732322676995190327.post-90714447437323007122008-04-11T02:11:00.006+02:002008-07-18T13:28:00.864+02:00BodiesFor my patient-doctor class on Monday, I shadowed one of my physician-professors, Dr. H, at the community health center where she works. She is a great clinical teacher who is gentle, dedicated to primary care, and invested in helping us learn. The first patient we saw had come for her yearly physical. Her primary concern was wanting to lose weight, and we calculated her BMI to be about 31 (which puts her in the "obesity" category - even more troubling than the "overweight" category). Dr. H spent a lot of time counseling her on nutrition and exercise, and set her up with a nutritionist. Everything went well, and then we got to the physical exam. During first year, we only learn how to take patient histories, but this was a special session where we were shadowing, not just practicing history-taking. So I proceeded to witness for the first time a Pap smear being performed. My instinctive reaction was, "This is kinda gross." I suppose that it's natural to feel awkward the first time you look into someone else's vagina, yet I couldn't imagine doing this as a frequent part of my career. This, despite Dr. H's incredibly nurturing advice: always warm the speculum first, press it downwards as you go in to avoid the more sensitive spots, slide it in at an angle. Shoot, I thought. No more primary care for me. My mind frantically jumped about, thinking, What specialty should I go into to avoid grossness at all costs? Optho? Psych? Radiology? Radiology?!? That is not why I went into medicine. I went into medicine precisely for the "grossness." I chose medicine because it requires getting you hands dirty with someone else's pain. I went into medicine because at its finest moments, it can be a very basic manifestation of compassion - taking someone else's burden and making it your own, standing with that person in their suffering, and fighting alongside them to give them relief. That means, at the very least, getting vis-ce-ral. There's a talk that Chris Nichols gave at an InterVarsity retreat I went to in college. He spoke on the passage where Jesus talks to an outcast Samaritan woman who had some really painful problems and Jesus probes into her life and what she's truly searching for. Chris painted this image of how we all have these wounds that we hide from everyone else, wounds that we cover with bandages because we think that no one will ever love us if they see how ugly we are. Yet if we let Jesus take off those bandages, if we let him touch our wounds, he won't humiliate us. Instead, he heals us. It may hurt at first, but ultimately it will set us free. That's the picture of doctoring that I want to emulate. I want to be a doctor that doesn't turn away from human suffering, human putridness, even human depravity. A doctor that embraces the rotten parts of human existence, and helps people be freed from their physical and spiritual burdens. I've got a long ways to go, I guess, if I can't even appreciate a Pap smear right now. Perhaps what my experience speaks to, also, is that during first year we are so far removed from what medicine is all about - patients, bodies, touch - that we are uncomfortable when we encounter these things. Things like skin, hair, mucosa. Things that bring back (to really probe deeper psychologically) what we saw in anatomy lab. A final note. None of the patients I've seen so far has a body like those that are so blatantly used on the glossy pages of magazine ads. None. Maybe as I become a real doctor and see more patients, I will stop thinking that the bodies I see in commercials are the norm. Unfortunately, the general public doesn't have the luxury of seeing the real norm, and thereby recalibrating their perception of what's normal.Kristinhttp://www.blogger.com/profile/12194078107819036706noreply@blogger.com