Wednesday, December 19, 2007

Double Communications

Our PBL patient is not doing so well. This case has turned out to be a lot more interesting than we had expected, because we had a diabetes PBL case last year too. But this one focuses more on the long term complications for patients who do not have controlled diabetes. Unfortunately, the truism that being an interesting patient is a bad thing definitely holds true here. The seminars were on gestational diabetes (pregnant women become insulin resistant and can even become diabetic while pregnant) and nutrition.

This afternoon we had double communications for four straight hours, which would ordinarily have been fairly painful. But, one of my group members didn't show up at all and another didn't get a chance to video an interview with a patient, so we actually got out about an hour and a half early. The first part of the session was about how to deal with family members being in the room. I got a mother-teenage daughter duo where the mother kept trying to take control of the interview. These were standardized patients, and the two actors I had were terrific. I would have totally believed that they were a mother and daughter for real. I was able to tone the mom down a little by turning my chair so that my side was to her and I was directly facing the daughter. I even managed to get her to leave the room, though she really didn't want to, and at that point I stopped. I could have kept going and done a sexual history on the daughter at that point, but I figured we've already done that lesson, and I'd gone on long enough.

The video reviews took another hour. I had been counseling my patient (a real one this time, the same interview that I taped last week) about smoking cessation, and I could have definitely gone further with that. When we got done, there were big, fat snowflakes falling outside. It was beautiful to watch, though what it did to the afternoon traffic was not at all beautiful. We haven't been getting too much snow yet this winter, but today is more than making up for that.

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