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Tuesday, March 05, 2013

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(note: long post primarily intended as a material archive)

I went to the SE Artwalk this weekend. I visited Amelia's studio, who let me babysit Miles to earn some extra money when I first moved to Portland. (Miles is now 13 OMG!). She asked what I was up to and I realized I've never really written about my work as a Standardized Patient, someone who acts in scenarios with medical students. I work with several different schools between Lebanon, OR and Vancouver, WA. Scenarios can include anything between a simple interview, a basic physical exam, or a full-on simulation w/ costumes, props & furniture, etc. It is SO much fun and I feel so lucky I have found the perfect spot combining education, acting and medicine.

When Amelia heard me talk about my work her first question was "Are you blogging this?!" I do post comments about my job on Twitter frequently, so here's a selected collection of my tweets with the #sp tag over the last 4 years. I imagine I'll update it as other interesting stuff occurs rather than creating a whole new post about it here.
all in a week's work: unplanned pregnancy, affair, angry street confrontation, stiff back, crisis homebirth, depression, rejected premed #sp
student compared abortion clinics to car dealerships: "well if you go to a Toyota dealer, they'll try to sell you a Toyota." #sp
"is there something good for you waiting at the end of this?" #sp #depression #bawl
If you touch me, the game is over. #sp #selfdefense
I like to use the whole scale, unless I'm punished for using the whole scale. #sp
nobody died tonight! #sp
reviewing "hail Mary" prayer for #sp case tonight.
you want me to play a character that asks a lot of questions? perfect! #sp
who am i this week? a hairdresser, a street person, a financial analyst, and a woman watching her husband die in the ICU. #sp
watching angry subway/street rant videos is pretty depressing. but i finally have a use for the guy who harassed me on the max last yr. #sp
student upset because my #sp character had an unexpectedly "male" name. "they'll be hearing from me about THAT!" he declared.
my comfiest #sp costume: big fluffy robe, tank top, sweatpants, handknit socks.
hey! i made my financial goal this month! #sp #march
f/u doesn't mean what you think it does. #sp
i sure do love acute cases. "i'm in a lot of pain and i have no idea why" means very little to memorize. #sp
next week is a big #sp week: 10 different cases & a training in lebanon. biggest stretch: 86 yo w/ congestive heart failure.
just ordered a stethoscope to do double duty as a play prop and #sp item. the best part: i can claim it on my taxes.
"you will no longer be subjected to safety pins." OH THANK GOD. #sp
just realized i'm two weeks out from the hardest event of the year and i don't have the scripts yet. #gulp #sp
made much more small talk than expected during depression mmi. "oh, you're fine? ok! what else can we talk about, then?" #sp
Today's case: Partying Pat! I love that I can pretend to have been at the @amandapalmer purple rain concert as part of my job. #sp
so it turns out being tired contributes quite nicely to Angry ER Patient. #sp
seriously, if you ever find yourself in a conversation saying something like, "don't feel that way," stop. #sp
that was a long day with a lot of concussions. #sp
Oreos: not the best snack food when a student is going to look in your mouth. #sp
today: insurance claims investigator w/ kidney infection. #sp
last of the resident HIV misdiagnosis cases till next fall. #sp
pro tip: don't tell a depressed person "nobody wanted to talk to you because they were probably afraid you would react like this." #sp
tomorrow's checklist has 60 items on it! #sp
@pdxmph "i guess that doesn't explain the coughing, but it would explain all the other symptoms." #sp
@pdxmph yes. and i had to use all my willpower to keep from laughing when he asked that. because he was serious. #sp
possible (wildly incorrect) diagnosis: "could you be pregnant?" um. not with pneumonia, dude. #sp
every school is different. every school is different. every school is different. #sp
good feedback with a student who had been told multiple times what was wrong, but not how to make it right. he left feeling relieved. #sp
i get to work w/ @Sven today! #sp
the scenario will end when they’ve "killed you, transported, concluded the post-hemorrhage education or they’re out of ideas." #sp
have you ever had to define the difference between empathy and rapport? i have. #sp
but I wanted abnormal mammogram results! #sp
it's nice to have a job where I have to pretend I feel bad when I really do. #sp
tomorrow morning i will be a jazz pianist. in the evening, i'll have just given birth. #sp #pendulum
so my hand mnemonic is coming along. #sp
tomorrow's #sp cases: knee, pneumonia, and Zombie Patient 0.
when i do smoking cessation cases, i fantasize about buying nicotine patches, even though i've never smoked. #sp
I'm timekeeper today; I guess that means I didn't ruin it last time after all. #sp
sometimes "i'm sorry to hear that" sounds like "i'm sorry you told me that." #sp
had a student tell me about blowing out his eardrum: "woke up with blood on my pillow!" gaaahhhh! #sp
gah. scheduling snafus. i wish events lined up in neater blocks instead of overlapping. #sp
if we want doctors who aren't afraid to admit mistakes, then #sp educators must model good behavior.
I love that I have a job where I have to ask myself: "How do people communicate sincerity, anyway?" #sp
ha ha ha! another high stakes case I haven't been trained for! let's DO IT! #sp
sometimes they pay me to recreate scenes on a felt board. it's way more interesting than it sounds. #sp
a whole week with no #sp jobs or obligations? this calls for adventure! just booked a bus to to the coast tomorrow.
WHY do I keep forgetting to give students the clue card? #sp #embarassing
pretty sure i'm not up for being an eye model: 8 weeks of eye dilation & an hour per exam. #sp
hmm. ncnm has invited me to return as an academic model. (good euphemism, btw.) #sp
monday i was a hockey player. tomorrow i will be misdiagnosed with HIV. #sp
amputation today! yay! #sp
and yes, I am a little fussy about ungowning instructions. clear instructions will save us both a lot of embarrassment. #sp
if I'm coming in for low back pain, why wouldn't you want to even look at my back? GRAAAAARRRR! #sp
it amazes me how few students are checking the area of primary complaint on this case. seriously! #sp
@TeenaKP i was an elementary school teacher in my #sp case today and tried to channel you. :)
you're still sending revisions to a case we're doing tomorrow? gaaaaah! #sp
today i'm a flight controller! #sp
my #sp scenario video was shown to the group as a good example, but like all i could notice was like how many times i like say "like."
today someone apologized for scheduling me so much because I was so "versatile" and fit so many cases. please don't apologize for that! #sp
"we usually take 3 hours to do this training." WELL WHY ARE YOU DOING IT IN 2, THEN? GRRAAAARR! #sp #intothefire
counseling an HIV medical error case in 12 minutes? WOW. this will be interesting. #sp
it's gross when a fellow #sp admits he likes "pretty young things feeling up my chest" and ends with "works for me, honey!" #grrrr #yuck
i'm having headaches again. i probably have 5-7 different headache cases a year. #sp
how can my low back pain both hurt constantly AND off/on? as if cases aren't hard enough to memorize. #sp
@AnStou the medical assumptions built into picking job occupations for cases is fascinating. #sp
@AnStou and i'm a divorce lawyer! probably not a lot of happy stone piles in my life. #sp
@AnStou tomorrow i will have diffuse bilateral lumbar pain with occasional radiation from left lateral thigh to left medial knee. whee! #sp
we're in an awkward #sp scheduling phase: lots of schools asking about availability, but no commitments yet. my calendar trembles.
using my #sp job in lebanon as an excuse for riding a bike in the willamette valley is pretty awesome.
#sp work is ramping up again. thursday i have a case in which i am a bartender who does not drink. what?
@TeenaKP #sp feedback: "leaving a patient unnecessarily vulnerable affects their confidence and trust in you."
met an #sp student on the safari to estacada ride. "you look familiar..." she said.
a student hit my knee so hard with a reflex hammer today i had to time out, rock around a bit in pain, and tell him to stop. #sp
tried not to wince when one of the students said, "oh! i've heard about you! you're tricky!" #sp
bad training begins "so this looks like a pretty easy case. you guys have any questions?" #sp
gah. i need to teach myself a good way to remember the difference between prone & supine. #sp
when everyone sets their timers at once, it sounds like a symphony. #sp
"can we stay and watch you change?" totally inappropriate, fellow #sp. :(
a new opportunity? "I have unique insight into ... communication skills that are often invisible in customer interactions." #sp
I am no longer a severely anxious medical student: neck, you can relax now. Please relax, neck. Please. #sp
still buzzing from ace feedback i gave a student today. #sp
eye makeup? argh. #sp
pantyhose. argh. #sp
practicing not moving the right side of my face #sp
#sp student during depression case: "your husband wasn't able to be there for you in the same way you would have been there for him." *bawl*
if you tell me when i stopped smoking, maybe you should tell me when i started. #sp
pleeeeasse don't ask me to be a med student as an #SP. it just makes the students ask me questions i don't know the answers to.
one of my students today said i had "nice tonsils." #sp
I know I'm doing feedback right when students want to keep talking to me after the event is over. #sp
resistance is fear. find the fear, face the fear. #sp #medicaladvice
also, that last case is one of my biggest fears as I age: progressively worse knee problems over 20 years till pain reaches 8/10. #sp
having knee/ankle injuries is making my job at the chiropractic college more difficult. I say, "that's me, not the patient" a lot. #sp
busy week coming up: 9 sessions, 9 different patients. #sp
sometimes I have a day where all students are pretty good -- and then one that runs us off the tracks. #sp
surprised to discover my personal doctor has observed at some of the #sp events at compnw. small world!
oh, right. THIS case. the timeline is... complicated. #sp
my assumptions about this #sp character involve a lot of makeup.
made it to centralia! late lunch while waiting for room. then I'll call my #sp client!
created timer announcements for my independent #sp sessions.
managed to book myself a job while traveling. i also managed to set myself up with 3 back-to-back cases to memorize by thursday. #sp
sometimes I think my standards are too high. and then a student simply nails it and I wonder why I ever doubted myself. #sp
well, geez, if you meant TB test, why didn't you just say that? i've been chasing this acronymn down for 20mins. #sp
when i am a depressed #sp: 1/8 students makes me feel relieved, 6/8 try to "fix" me, 1/8 makes me feel much much worse.
I eavesdropped on someone's feedback session through the wall. I wish I could do that more often. #sp
that was a really great day for feedback. #sp
bike pain case tomorrow morning! yay! (also, unrelated sexual history case in afternoon. :) #sp
you want my opinion about #sp work? excellent!
#sp scenario w/ @Sven, jalex & me! small strange wonderful world.
head still draining: partying cousin, rejected medical student, depressed grade school friend all in one day. #sp
both my baby & i survived tonight's scenario! that's a first. #sp
makes me wish siri could control voice memos, so i could rehearse while riding bike to work. #sp
bloody genius: i recorded myself asking questions about my cases in voice memo. now i playback and quiz myself! #sp
some schools value #sp feedback, whereas some schools treats SPs like animatronics.
next week i'll be 11 different people. these are the only exams i write notes for. #sp
if i am depressed, telling me i am "unkempt" is unlikely to help. i almost burst out laughing, so i had to act offended instead. #sp
I love having a job where I can read hyperbole and a half to get into character. 
pleeeeeease don't make me get up at 5a if i don't have to! #sp #snowday
seems easy: phone cases are less memorization. but i have to hit 3 very different emotional tones in 3 different phone calls. whew! #sp
having my bike stolen helped me play "angry ER patient" with particular verisimilitude today. #sp
it's nice to come back from an audition with an email already waiting: "we hope you are interested in taking the next step." yes! #sp
quick bruise recipe: red base, blue & purple dabbed in center, yellow & green on outer edges. apply to cheek or wristbones. #sp
#sp casebook: female w/ fatigue: domestic violence. male w/ fatigue: car crash/failed rescue. hmmmm.
feedback today: "you're adorable. but adorable isn't a quality i'm looking for in a doctor." #sp
does your job include electrodes? if not you're totally missing out. #sp
heh: "which readings/textbooks did you find MOST useful?" "Gretchin!" #sp
why do you ask me for more time? you know I cannot give you more time. #sp
first year students take such different blood pressure readings! #sp
why do you call me a "volunteer" if you pay me? #sp
it's apparently my natural instinct to take a solitary event and try to systematize it. :) #sp
finally! a "party girl" case! my boss once told she couldn't see me in those because i was "too pure." #sp
q: did anything happen 3mos ago? obvious answer: "i moved from seattle to portland." correct answer: "nothing i can think of." what? #sp
i saw these same students last week in a very different context. i had to work extra hard to stay in character based on their reactions. #sp
if you can't pronounce "allergies," then i can't recommend you become a doctor. seriously. it's a life-threatening issue. #sp
working w/ ohsu admissions today, evaluating candidates via scenarios. ee! #sp
best quote from a frustrated student: “making a patient uncomfortable makes me nauseous.” #sp
sometimes I feel like Troy McClure: "you may remember me from such cases as Cranial Nerve Exam!" #sp
feedback I never thought I'd have to give again: "never joke about beating a woman with a hammer, even if it's just a reflex hammer." #sp
ha ha! i love this case! "You are retired but very active on the senior citizen social scene..." #sp
I love it when I figure out a new piece of feedback to give students. #sp
headed to an ultrasound anatomy class. #sp
THIS is what i do! #sp
have to learn hymns for this character! #sp
working at the chiropractic college always makes me hyper aware of my posture. #sp
told a student never to joke about beating/bruising women during a doctor visit. #sp
have you ever needed to count backwards from 100 by sevens? it's tougher than you think. #sp #lifeskill
i love acute pain cases. tip: don't talk over a patient who is clearly exhibiting signs of short, intense pain. #sp
today's #sp smokes medical marijuana.
as an #sp, the latest xkcd really cracked me up. my students would freak if i did this to them. :)
View on Twitter
first time in a scenario where I almost died! AND I lost my baby. :( #sp
off to give birth! #sp
did a #bike case today! numbness & tingling in pinky & ring finger due to a new bike. #sp
@pdxmph ha ha ha ha! :D alas, no. but i get called "heather" and "rachel" a lot, so i use them as #sp names.
i finally have a use for all the mistaken names people have given me over the years! #sp
haaaaate the sharp/dull tests at uws. they use actual safety pins, rather than a toothpick. #sp
reviewing women's weightlifting sites for an #sp case tomorrow.
reading birth stories from "spiritual midwifery" to prep for #sp case next week.
even if just playacting, 8/10 pain for 45 minutes is still hard. #sp
i feel like i'm cramming for finals #sp
ready? i'm going to be 13 different people this week. #sp
hates it when the case specifies i haven't taken any medications. 10/10 pain and no advil? REALLY? #sp
starting to lose track: who am i tomorrow? today i said i had rheumatoid fever as a kid, which is a character for another school. #sp
tomorrow i will be 14. how's that for a wide range of acting ability? #sp

Saturday, March 02, 2013

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well this was a pleasant trip. i found the perfect picnic spot near a bubbling creek.