As many who follow know, or at least likely think when they read this, the time nears for my next number.  I reflect on this and thinking about the last post which talked about my idea of a pool in which folks would “predict” the upcoming PSA.  If I were to move forward with that idea, now would be the time to start taking the predictions, the wagers if you will.  But alas, as I previously noted, too many found the idea offensive and so it shall not become a reality.

What this number does bring with it however, is several milestones of sorts.  It was five years ago this week that I my general practitioner took my first PSA and identified a problem with my prostate gland.  It was quite the memory and something that really sticks in my mind, not because of the reason or results of the visit, but for the visit itself.  You see, my then family doctor practiced at a university clinic and in doing so often supervised residents who were doing their rotation.  This visit was no different and when I was in the examining room the first person to see me was a resident.  Now this was not the typical resident, she was a young woman, perhaps 23 or 24 years old and more importantly, this was her first day.  Most have probably gathered by now I can be a bit of a jokester and this was an opportunity of epic proportions.

So, in came the resident, I recall her saying her name was Molly.  She began by explaining she was a resident and she would be getting my information.  She opened her clipboard and began asking the questions in the order they appeared.  It was clear she was a bit nervous and so I began distracting her from the task at hand by asking somethings about her.  I learned she came from a rural upbringing and so I told her of my pet cows.  It was within this context she revealed this was her first day.

Back to her taking my information, she reached the point where she had to fill in the part about why I came to be seen.  It was about describing my “problem” and the associated symptoms.  Again, as those who know me can attest, I am not exactly a shy person and can be quite matter of fact when it comes to these things.  She was writing, listening and writing some more.  During parts, those which described my situation more graphically, I could see her sort of “withering” in her chair and burying her head in the papers – she was uncomfortable.

Shortly after she finished getting my information I again broke the ice a bit with some small talk – why she chose the school, where she did her undergraduate work, why she wanted to be a doctor.  She seemed to be a bit more “composed”.  But then in came my doctor, a tall, lanky kind fo guy with a very soft manner and who took the socratic approach with the students.  He opened the conversation by asking the resident, “so what did you find out”?  She once again withered and began describing my symptoms.

During her description it was clear she was a bit uncomfortable with conveying exactly what I had told her.  She struggled for the words to accurately describe things, but failed to retain the clear picture – I decided to “help” her.  So as she offered her description I would interject, stating very bluntly the symptom she struggled with conveying in a “sanitized” way.  Each time she would slouch in the chair and kind of look down, look away from the doctor and I and so things migrated to the point of basically excluding her – too bad really.  We then moved on to the exam.

The doctor, following my satisfactorily answering his questions, began checking all the things he normally checked – ears, nose, eyes, throat and so forth.  During the process he occasionally asked the resident for her assistance or directed her to look as well.  Following the typical examination, we returned to the topic of why I came in the first place.  He suggested several possibilities in response to the described symptoms, but shortly into the exchange it was clear the problem was likely associated with my prostate.  We spoke in some more direct terms, during which he stated it was unusual for someone as young as I to have a prostate problem.  We concluded it appropriate to do the exam nearly every man dreads – a DRE (digital rectal exam).  The resident looked something like a ghost.

With that decision, and this being my first experience with such a procedure, the doctor instructed me ow to proceed.  I followed the instructions and in doing so it was possible for me to see the resident, sitting in the chair at the little examining room table, hunched over and looking down.  I’m sure this is not what she expected would happen with the very first patient she saw as a resident.  The doctor did the test, noted a couple of things verbally, directing the resident to write it in my record.  He mentioned a couple of things to me as well and decided to perform the exam again, I sort of began thinking he might like doing these exams.  He again directed the resident to write some thing in the record.  For me, I started thinking he may want her to take a shot at me as well, not really a problem I guess, but he must have sensed the same discomfort I saw in her and simply instructed me to “reassemble”.  We began to talk.

The resident, still sitting at the little table, now seemed to become a bit more interested, a bit more engaged in the conversation.  The doctor described what he felt and possibilities.  His manner did not change from his usual presentation.  I asked some questions and the resident remained intent on hearing his responses.  I was thinking she was learning something, something she had come there to learn and something providence intended for her.  It was interesting, gratifying in a way because I thought this would be something she would hold, one of those things she would never forget because it held special meaning; perhaps she will gain an appreciation of prostate cancer, maybe she’ll chose to alter her career direction, perhaps many things because of this experience, because I was the first patient she saw as a resident doctor.

As always, feel free to comment or you may email me at lifeabstractions@gmail.com

ciao

Lifesabstractions

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