Hitting my stride

As is often the case in clerkship, it is only in the last week that you start to feel comfortable in the rotation. You know how the system works, where to find requisitions, who to talk to to get things done, which nurses to be on the good side of and the preferences of the staff you're working with. All in time, of course, to switch gears entirely and start something new. (I think I talked about this in the first post, so I won't belabour the point, but it really is the clerk's life for a year.)

In any case, I felt that I really hit my stride this shift. Presumably... I don't actually know what hitting one's stride is like. I hate running. Anyway, I was seeing a lot of patients on this shift, generating differentials that made sense, coming up with management plans and figuring out dispositions for patients, most of which was on par with the plan my preceptor came up with. It felt like I was making a substantial contribution to the team, which is always a nice feeling, no matter the line of work.

After my diatribe about alcohol in the last post, I thought I was going to go a full shift without seeing an intoxication injury... I was seeing lots of standard complaints (syncope, vomiting, toothaches etc) and it was approaching sign over time without a whiff of EtOH, when I pick up a chart that reads "Patient was drinking last night and got into a butter-knife fight with friend".
Seriously?? Who does that? It wasn't even one of these "I punched a wall, honest" types. He and his friend legitimately had a butter knife fight, for fun. I guess I appreciate the honesty.

He had a little slice that we glued shut before sending him on his way... I'm never sure how to handle these situations though. I suppose you have to read the patient. If they're laughing about it, I think it's okay to laugh as well, but they aren't always, and that can make for tense times if you crack a joke or throw in a dig. We aren't only students of medicine, but students of interpersonal interaction: sometimes that's half the battle.