Makomed's Weblog

My Career So Far…

Posted on: December 5, 2006

This is a reprint from my old blog.

Ah, what to write for my sophomore entry. Guess I better start with my healthcare experiences. I think I’m going to save my military medical experiences for later since there’s so much to tell, but stick around and I’ll invoke a flashback or two.

Anyway, I’ve been in healthcare as far back as high school graduation, many moons ago. I’m not obsessed with medicine (yet), but I don’t seem to mind it at all. After finishing my stint with the service, I studied hard—challenged the vocational nursing board, and got my vocational nursing license. With this, I started working for the most awesomest doctor in the world, Dr. Shirl. She was the coolest doctor in UCLA. UCLA helped me round out my medical experience because Dr. Shirl happened to specialize in gynecology (though she hated OB). So she had oodles of female patients and I had to prepare them for procedures like endometrial biopsies, intrauterine device removals, pap smears, and colpos. Because I worked in the Marines Corps, there weren’t very many female patients for me to take care of, so working here was eye opening for me. Man, there was this one time that this UCLA student came in for vaginal exam and there was this awful stench that came out of her legs that smelled like really really old blood. She said her boyfriend had begged her to get seen because he didn’t think it was natural to have that odor. The doc scooped around in there for a bit and pulled out this tampon that must’ve been inside her for months, no joke. It had absorbed so much of her bodily juices that it looked like a reddish-brown diaper! The room reeked so I had to throw away the trash immediately as soon as she left. I’ll never forget her face when she saw what was coming out of her. She was like, “Oops! Tee-hee. How did that get in there?” But still, guys are more disgusting than girls will ever be. I can’t tell you how many yucky hairy butts I had to look at when I was giving recruits hundreds of penicillin shots. But that’s enough grossness.

I also had my first taste of medical politics. Sometimes I had to bring in patients for Dr. Marty, too. He was one of those people who probably had a building named after him in UCLA. I read his CV once and he was UCLA all the way: as an undergrad, a medical student, and a resident. He was a type-A that would go to meetings with the Chancellor, and then dash to the clinic to see patients. More often than not, he would cater to UCLA’s elite that usually consisted of the Law Professors, Million-dollar donors (think David Geffen), and those of that ilk.

A prestigious title does not an ideal patient make.

In fact they were the worst, most demanding bunch. They felt they were above waiting in line and insisted on seeing Dr. Marty right away—even though he wasn’t even in the building yet! Then they would chew me out if they didn’t get their Viagra right away. I tried in vain to subtly tell them that if they weren’t so cheap about medical insurance, they could get their meds faster. But they continued to clutch their HMO policies and wondered why they were “being neglected.” You don’t know how irritating it is when I’m on hold waiting for the insurance company to get clearance on a med for a patient who is suffering from a real affliction, trying to take vitals on an agitated patient who’s probably a hypochondriac, and then having Law Professors badger me for their erectile-dysfunction meds so they can get it on with their 22-year old wife when they arrive in Nassau, Bahamas!

Needless to say, I began to lose a little interest in Family Practice/General Medicine/Internal Medicine, which was a little sad because I absolutely loved it when the Marines would ask me for all their medical needs. It was nice to be the first person to talk to if they had medical concerns for themselves or their little kiddies. But one should take into the account that a doctor in a lively metropolis working for a huge practice like in a university, getting paid through money-hungry insurance companies will often run into ungrateful patients. This is also why Charles Drew, Loma Linda, Riverside/UCLA are attractive options for med school—because they train doctors to work in urban environments that are considered less prestigious (like thug ‘hoods or in poor countries). Too many doctors opt for working in upper class cities to earn more money which means patients get spoiled.

Regardless of the outcome, I learned a lot. I was finishing some science classes at night over at Santa Monica College—but it proved to be quite difficult working full time. I ended up pulling all nighters at Denny’s in Westwood and sleeping in the car at the UCLA employee parking lot just so I wouldn’t be late for work the next day (back then I lived near LAX). To all the UCLA students, I’m sorry if I spit my toothpaste foam at you from above when I was brushing my teeth in the fourth deck. It was an accident.

One thing that helped me out though was being able to decipher labs. And labtestsonline.org was a blessing! God bless this site as it has helped me to understand confusing test results. Sometimes Dr. Shirl would be so busy she had me discuss minor lab results with patients who were itching to know them, because she was too busy to do it herself. I learned a lot about PTT, CBC, Chem, Liver Panels, Hormones for thyroid problems, PSA for guys with messed-up prostates, UA, et al. Boy, you sure can tell a lot about a person from their lab tests.

One of the best memories I had was trying to coach Nicole, a first year med student, into building up confidence. This was her last shadowing session with Dr. Shirl, and Dr. Shirl wanted her to see a roomful of patients on her own! The whole family was in there, waiting to talk to a physician. Nicole was a beautiful blonde girl that would get most guys to look twice, but she was painfully shy—you could tell from the way she slouched a little. She peeked and saw the family of the patient in the room and got frightened (it was especially scary because two of the family members were attorneys at a well-known firm in Downtown). I tried to warm her up so I reviewed the mechanics of taking vitals with her, gave her tips on what Dr. Shirl would expect from a thorough SOAP Note. She was getting quite antsy and pacing the hall, so I grabbed her shoulders, glared at her, and said, “Nicole. You can do this. You are smart and capable. You’re a UCLA medical student for goodness sake! You are almost a doctor. No, you ARE a doctor! Look me in the eyes, Nicole. First impressions are key. When you walk in that room, show them that you have confidence in yourself, and they will have confidence in you.” So she took a deep breath to compose herself. I opened the door to greet the family and thanked them for being so patient. I then told them that Dr. Shirl wanted to have her assistant, Dr. Nicole, come and examine the patient first. This was fine with them, and that was Nicole’s cue to enter. And boy, did she ever! She sauntered in with perfect poise, like a Victoria’s secret model, sat down, made direct eye contact with the patient and her family, crossed her long legs, smiled in a cocky (but not too cocky) way, and proceeded to ask the patient about his history. I was so proud of her when she came out and gave Dr. Shirl a concise report of the patient’s history, examination, objective findings, assessment, and proposed plan.

That was one of the fun moments working for UCLA, but working and being a college student began to take its toll. I had enough of sleeping in the back of my truck so I decided to talk to my boss about working part-time, or at least letting me work for Dr. Shirl exclusively. But she wouldn’t have it. She said I could only work full time or not at all.

I was beginning to get depressed at the thought of having no life whatsoever but then I remembered that one of our patients had been trying to get me to quit UCLA and work for her and her bedridden son. She said it was easy work and she would have no problem with me studying for school as long as I monitored her son. I was always declining her offer but now it didn’t seem like such a bad idea. It was perfect timing when I saw that she was due for a visit the next day…

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