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Tuesday, March 05, 2013

 
3:35 PM: notes from a professonal patient [#] [0]

(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 http://www.oregonlive.com/health/index.ssf/2011/08/oregon_health_science_medical.html

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. :) http://xkcd.com/883/

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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