Friday Clinic, Day One

After an altogether terrible night of sleep, I crawled from the warmth of my bed, tripped over a few diapers and other remains of an angry 6-month-old who had thoroughly exerted her dominance over the hours between midnight and six a.m.  Her authority is not to be trifled with...  However, despite the rough beginning, this day was meant to be a special one.  My first experience with "real" patients and day one of the clinical portion of my training.  Up until this point, I had been spending countless hours cooped up in a windowless classroom under a constant barrage of power-point slides, graphs, and endless lectures.  This day, however, I was going to break free of the constraints of the classroom and venture into a whole new world where I was going to interact with actual patients and start applying the ridiculous amounts of information that I had so diligently tried to cram within the limited confines of my brain.  In the classroom, our professors have been indoctrinating us with not only raw medical knowledge, but instilling in us time-honored ideals and principles of medical practice from such medical legends as Sir William Osler and many others who have paved the way of modern medicine.  Our "classroom" world has been one where time was not an issue.  Meticulous medical histories and physical examinations were performed, and careful, often painstaking thought was given to diagnoses, medications, and treatment options.  Details of the history and physical exam were explained and carried out in great detail making sure not to leave any information unexplained or left out.  Needless to say... my expectations were high, perhaps too high.  To my surprise, this new clinical world was light years away from the comfortable classroom atmosphere to which I had become so accustomed.  It was really strange to me that I was actually surprised by this since I had spent so many hours working in busy hospitals, clinics, and emergency rooms before entering PA school.  Yet, there I was, feeling slightly overwhelmed by my current situation.  Perhaps it was due to the fact that I had never actually followed a patient from check in all the way through the actual visit and was used to doing procedural type exams and tests and then moving on to my next patients... Or maybe it was the fact that I was now standing on the other side of the fence, stepping into the role of provider which allowed me to see things from a completely new perspective that was previously unknown to me.  Time was one of the things that really shocked me... the sheer speed of the entire encounter was less than a fourth of what I was accustomed to.  Parts of the history and exam that would have taken me thirty minutes or so individually, were done in less than five minutes all together.  "Semi-controlled chaos," I believe were the words of my preceptor when describing the usual pace of normal clinic life.  This being my first day, things were actually pretty slow compared to normal due to some of the logistical things that had to be done such as HIPPA training, orientation to all of the areas of the clinic, and meeting the majority of the staff that I would be working with over the next 24 weeks.  I was however, able to work with a handful of patients throughout the morning and afternoon, just enough to ignite my curiosity and desire for more in the weeks to come.  I was not overwhelmed... (yet), and was at least able to get comfortable enough in my surroundings to prepare me for times when that would definitely not be the case.  All in all, my first day was exciting and a great first experience in this new "clinical classroom."  I am really excited to see what the next 24 weeks will bring, and am anxious to see how much I will grow this semester as I move ever closer to the end of my didactic training, and enter the full-time clinical rotation phase beginning later this August...  I did learn one very important lesson by the end of the day... I have a LOT to learn!