It is my last week of Internal Medicine, which means several tests, portfolios, and an OSCE. Gotta admit, Internal Med has been harder than usual this year, and I was shaking like a leaf before the exam began today. As you can see, I survived. It actually went reasonably well, so now I just have to worry about passing the written tests.
When I’m about to freak out about a difficult case presentation, I always remember the above quote.
One of my favourite doctors, a rheumatologist, always has great ways of imparting knowledge. I first met him in my third year, when I had a patient with Dermatomyositis. Our patient was globally weak and could hardly speak. The doctor proceeded to tell me about The Diving Bell and the Butterfly by Jean Dominique Bauby. Since then, he has recommended books to me every time I see him. (So you can see why he is one of my favourites!)
But anyway, at a more recent tutorial he gave us a nice pointer regarding patient presentations (especially for OSCEs). Quoting from The Adventures of Alice in Wonderland by Lewis Carroll, he said, “Begin at the beginning, and go on until you come to the end, then: stop.”
This is great advice for any medical student, regardless of rank, because one of the most difficult things in presenting a patient is knowing what is relevant in the story, and to know when is a good time to stop. Stopping at an appropriate time rather than rambling on until the consultant silences you, gives the impression that you know exactly what you are talking about – even if you don’t!
P.S: I just found this post, from when we had to do our first ever patient presentation. Funny to see how far we have come. Back then it took five of us several attempts to do a history and a physical examination; these days seeing a patient alone is perfectly usual.