free clinic

I've been volunteering at our free clinic and have been really enjoying it. We have a LOT of time with our patients, and because it is an all-volunteer staff, everyone is usually pretty cheerful about being there. It's inefficient because the students are new, but in many ways I think the patients get better care because we all spend at least 30 minutes with them and are super-thorough in our exams because we haven't yet learned which shortcuts to take (appropriately).

We also get to have a lot of responsibility and do procedures and exams that you couldn't/wouldn't do on paying patients (or who would not let you attempt). For example, today I assisted with a pap smear, did a bimanual (vaginal) exam, and drew blood for three patients' labs - hitting veins all three times on the first try! We haven't even officially learned to draw blood yet, and the gynecologic exams are basically the grand finale of second year med school. But for regular people (i.e. not elderly people with collapsed veins or extremely overweight people) I feel reasonably confident about blood draws. The initial nervousness passes quickly when you just HAVE to do it.

Most med students don't even get to do a pap smear even while they are on the wards, so this is some pretty great experience to have now, esp. as a mudphud with multiple years to go before I see anything clinical (at least officially). And I just got thrown into it all today with literally less than thirty seconds of direct instruction. Admittedly, I have seen the procedures enough times to not worry much, but it is different doing them. It reminds me of being a kid and deciding to go off the high dive - I would always climb up the ladder and run off the end before I had time to get scared and freeze. Then it's just free falling till you hit the water, for better or for worse.

I think procedures are like that too. You just do them and don't think too hard about it. The first time you stick a needle into someone or probe some intimate area (whether physical, emotional, or otherwise), it's a bit scary. But after a while you get comfortable with it all.

In normal society, the body and all the things it does are rather private and surrounded with taboos (and occasionally obsessions). In medicine, one cardinal thing to learn is to let go of normal societal taboos and customs and just be comfortable with the body. It's a great privilege and responsibility of our profession that we are privy to the most intimate areas of people's lives: mind, body, emotions, and spirit. What we do with that privilege and how we handle it is something I am still learning more about. But I love the spirit of free clinic - it's to me what medicine is really about, for the most part unencumbered with the time crunch of a "real" clinic or hospital.