today we have the second clinical of gastro block. i felt so guilty as no one volunteered and the same people had to step up (including my clinical leader). gonna study endoscopy consent form earlier so that i can volunteer next...
since the dr in charge to teach us today is a psychiatrist, we had to take history from a psych patient who also happened to be a doctor. everyone was strangely quiet and our dr was mildly frustrated. sometimes the patient chipped in his tips during the physical exam and he got bored midway so he just fell asleep. throughout the inspection, so many patients were peeking from behind the curtain, and a few patients were hovering around the ward. we actually signed our cex forms earlier... and there is only one person who hasn't gotten their cex forms signed, it's really a wonder why he did not want to volunteer.
at the end of exam, he left his spectacles on the bed, so i had to bring it to him and called him but he was in a daze and i ended up getting rebuked by my doctor.
we reviewed back the session and one of my groupmates reasoned the silence because of our stigma and biases. he said, we're scared of asking questions that might trigger the patient's aggressive episode. like... why are you representing us... our doctor was shocked and said, would you think this if it were your girlfriend? boyfriend? parents or family members?
another said that it's because the patient was normal (no gastrointestinal pathological symptoms), but in reality, some patient might not have every textbook symptoms upon checkup... so this should be a practice as well.
actually, our patient had bouts of vomiting, little sleep and hyperactivity that affects his overall mood, so he was admitted under the diagnosis of bpd. he also mentioned that he had history of hypothyroidism upon clerking. then my groupmate asked if the patient can still be a doctor (he's a general practitioner) after discharge, and our doctor was like, of course. do you know how many of you (medical students) that i'm seeing? maybe this is why they send to you to us (psych department when the current block we're learning is gastrointestinal). to correct your preconceptions in other domains. think about it, our doctor said, would you stop your study when you're diagnosed with depression, a very treatable condition? the same goes with mania.
reminds me of my groupmate who said serve him right to a hiv (appropriately, we should use rvd - retro viral disease) patient in a case after reading his sexual history of homosexuality.
stigma from the medical practitioner who treat people themselves is the worst.
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