Day 1

So today was day 1 of my college after the pandemic, and professional examinations. And I was super excited for it, and trust me it was totally worth the excitement! Since we are in 3rd semester now, so we have hospital postings along with the normal theory classes and practicals. It is finally the time to see all the stuff that we had been taught in the books. 

We have Medicine postings for the next 20 days, and it is definitely an all-in-one posting.There are all kinda patients- starting from basic fevers to many neurological patients can be found here. 

Today, we were allotted one patient and we were supposed to take his history. 

So it was 30 year old man with icteus for the last 1 year. He had Diabetes since 4-5 years and is a farmer. The man developed cough and chest pain for last 3-4 months. He had been consulting various doctors but his condition did not improve, and thus he was admitted here for last 4 days. 

Since it was our very first day in a ward and in the hospital itself, all of us were pretty hesitant to go forwards and ask the patient history and examine him. It was a very basic list of questions but it just felt very awkward to ask the person. 

So anyways, we decided that we will first note the history and treatment plan as shown in his pre-existing medical record file and then fire him with questions.We went on to read every page and every report in the file and all of us were trying to make witty remarks about each report. 

After a rigorous 30 min flipping and discussion, we concluded that the man had post-hepatic jaundice. 

Then some of us proceeded to talk to the patient. We asked his name, the place that he is from, occupation, education and date of admission. And then we asked the chief complains (again) and took the history in a very much haphazard manner. There were 4 of us shooting questions on the patient and his wife, standing on both sides of the bed and the patient was trying his best to answer all of our questions. We were trying to ask open ended questions in the initial conversation and then close ended questions were on the plan but we never really got to that. LOL. And somewhere in between asking questions and taking history, some of us took his pulse and pulled down his lower eyelid to check icterus (even when it was clearly visible; and that was me and my friend :facepalm: )

Next, we were finally addressed by a doctor who gave us a detailed picture of how we are supposed to take history. And we were also told about the books that we are supposed to read. The best part is we actually really SAW a patient and this is just the beginning. 

Bonus: There was a patient in the adjacent bed, who was just admitted and he had chronic demyelination leading to a very interesting spectrum of observation. A senior doctor was examining the patient and we were just trying to understand as much as we could. It was a young boy (I'm not sure about the major complains but the findings were interesting). His corneal and conjuctival reflexes were absent (The doctor gently touched the corner of his eye with a tuft of cotton and the boy did not blink at all), his reflexes in UL and LL were very diminished and he could not properly protrude his tongue or speak. The boy also had ataxia, He was asked to tandem walk with someone beside him and he swayed to the sides. So there is involvements of CN3 to CN10 and cerebellum. A CT scan focusing on the posterior cranial fossa was to be conducted. 

TBH, I am much more excited about the second case since neuro seems very fancy. 

Tomorrow, we have this again! Let's see how that goes :)