The most useful thing I learned in my recent six week stint with the psychiatrists is that psychiatrists are doctors too. Here's the evidence:
- They know all about "Code Brown".
- They get really annoyed at inappropriate referrals, such as the person with confusion due to an infection that the ED docs think is bonkers and should get detained and given anti-psychotic medication rather than something more appropriate such as, say, antibiotics.
- Their handwriting is illegible.
In contrast, the surgical team I've just joined, while they also have unintelligible writing, don't seem to be able to use sentences in their notes. To be fair, this is probably because they are scribbling madly, desperately trying to catch up with the surgeon, who conducts the round so fast that windows are shattered by the sonic boom.
It's pretty intimidating getting thrown into the midst of this as a student because it means that anything in the notes is thruply confusing. Not only is the handwriting terrible, the actual text is just bizarre abbreviations of things that you wouldn't understand even if it was actually written out in full. On the round this doesn't matter so much because as a student my main tasks seem to be to hold the tongue depressors in case anybody wants to do some Playschool craft projects and to not get trampled underfoot by the aforementioned rampaging surgeon.
Clinics though - clinics are a different story. Today I was given the job of taking notes, which is fine (in fact, the surgeon told me I was a "born note taker", which may actually be an insult, but anyway) except it means that I'm holding the notes and hence also have the job of flipping around in the previous notes and trying to answer questions about the previous appointments.
The surgeon would turn to me and ask something like, "What was the original plan when Mr Smith first presented last year?". I'd find the page and see that it would seem to say something like, "P) OPO f/u A/S2 w C+R". Now if you're roolly smart like me you can mentally adjust for the scrawlings and say, "Outpatient followup up in 1 month with a chest x-ray". Which is fine.
But the next line says, "2. FFfFt + ananas - ref/ chok", and what do you do with that?
I can't figure out what it means, nor even what it might mean. The nihilistic part of me wants to throw caution to the wind by saying, "Klaatu barada nikto", just to see what happens. However, that is not how you establish credibility on day 2 of a new clinical placement. It's more suitable for a morning tea in week 5 when everyone already knows you're a bit of a nut. So I simply say, "It looks like the plan was for fffffft, ananas and ref chok."
The surgeon pauses and stares at me long enough for my heart to skip two beats. "Hmm, fair enough. It wouldn't be my approach but I'm pretty conservative", he says, and carries on.