Today was officially a day off from school for Martin Luther King's birthday, but I had geriatrics clinic this afternoon, so I still went in. The geriatrics clinic is on campus in the Crile building, and its function seems to primarily be to evaluate older people who are having memory problems. I was mainly shadowing today, and I saw four patients at various levels of orientation. The first one was very sharp and knew where she was, the day, date, who was president, etc. She even made a comment about how much she dislikes President Bush. This was in stark contrast to the last patient I saw, who had early-stage Alzheimer's Disease. That patient had fought in World War II, and he was telling me all about what he did and saw while he was in the service in the 1940s. But he had no idea what day today was, and he thought this month was October of 2003.
Overall I thought working with older patients was interesting but also kind of sad. All of the ones I saw today had lost their spouses, and they were relatively limited as to what they could do compared to how they were before. It's clear that they start losing their short-term memory way before their long-term memory. One funny thing that happened is that one of the patients got tired of waiting for the doctor and wanted to leave. There was a resident in the room with us who was examining her, and the patient told the resident that she had been here long enough and she was leaving right now. The resident was trying really hard to convince her to stay long enough for the attending to come see her. We finally had to get the attending out of another room with another patient before she would agree to stay.
I just finished my CAPPs for this week; we got an extra day to do them because of the holiday. This week, we have an unusual schedule. We only have two PBL sessions instead of three, and our anatomy lab is tomorrow after FCM. Tomorrow is going to be one hell of a day. I get to start it off with FCM. Then we're covering anatomy of the lower limb, which I haven't had a chance to do much reading for yet, and to top it all off, I have my normal clinic in the afternoon. I'm supposed to be practicing the neuro exams, which I am still not familiar with and don't feel comfortable performing. I am thinking that maybe I'm going to have to ask my preceptor to show me the tests again and watch me perform them, at least the first time. Sigh.