Taking the plunge

Looking back on myself three years ago, when I first started out on this grand *adventure,* I realize how much things have changed. I remember being a first year medical student at my clinical preceptorship, charged with the assignment of "go see what's going on with Mr. Johnson." I would stand nervously outside Mr. Johnson's door and carefully pluck his chart from its plastic wall holder (this had to be done as delicately as possible so Mr. Johnson wouldn't be tipped off by the tell-tale paper rustling as to the presence of someone standing nervously outside his door). I would flip through his chart, trying to glean some sort of helpful information from reams of unintelligible documentation. Maybe the chart would tell me what was going on with Mr. Johnson. It rarely did. It was undecipherable to me. Then I would spend the remainder of my few minutes of akward-hallway-standing trying to plan out an appropriate opening line, practicing in my head what it would be like to actually knock on the door, open it, and be standing face to face with Mr. Johnson himself, who may or may not be half-naked. Then, after jotting down some notes of the questions I wanted to ask him (word for word, of course) and convincing myself to not think about what he would think about me, I would raise my hand up slowly and knock. Every single time I saw a patient it was like this, like taking a plunge from an uncomfortable height into very cold water. I had to mentally prepare. I had to hold my breath. I had to be ready to flounder around in the water for a while, and possibly drown in my own insecurity.

And now. Now! Now it is so much easier! I see multiple patients a day. I knock on their doors, I introduce myself, I ask them personal questions, I look in their ears, I ask them to take their shirts off, I palpate their breasts. (Not on every single patient, of course.) Its so refreshing not to be filled with nervousness, not to agonize over what on earth I will possibly say when I open that door. I just open it.

And its weird - most of the time it just works out.

But there's still a group of people with whom a little of that pre-knock nervousness returns. The mid-to-late-twenties male patient. Guys my own age. They are scary! They pose a problem for me for several reasons: 1) they might feel uncomfortable talking to me, 2) they might question my right to be there, 3) what if they are cute?, 4)what if they misconstrue my naturally comfortable, easy-going bedside manner as flirting? 5) if a young, healthy guy is seeing a doctor, its usually because they have a very private, embarassing problem that, after months or years of stalling, they have finally convinced themselves to be seen for. Granted, most of this is likely in my head, and its nothing that a little professionalism couldn't overcome... but seriously. I feel akward.

Such a situation nearly presented itself today, but fortunately my preceptor took a look at his age and said, "28 year-old here for a physical? There's gotta be something going on. Why don't you sit this one out." And there was something going on. Going on "down there". And if I had gone in there, with my confident hand-shake and comfortable questioning, she is convinced that he never would have told me.

Just goes to show.