Free Everything I Learned in Medical School: Besides All the Book Stuff by Sujay M. Kansagra Md Page B

school and allow students to examine their breasts. We divided into groups of five or six, and unfortunately, I was placed in a group of all females, which only added to my sense of discomfort. The instructor gave us step-by-step instructions on how to position the patient, and how to properly examine the breasts. This involved walking our fingers over every inch of the breast and pressing down with different amounts of pressure to feel for any masses. When it was time to perform the exam, it became obvious that this technique took a painfully, awkwardly long time. As the exam started, thoughts were racing in my mind regarding the best way to stay cool and not appear uncomfortable. Usually when you are this close to a patient and examining them, you talk to them to break the tension. But what do you talk about when you’re examining someone’s breasts? “Lovely weather we’re having.” “How about those Mets?” Perhaps I would just keep my mouth shut. It was a little easier knowing this woman had her breasts examined all the time, and that this was not weird for her in the slightest. This fact made me more confident and less self-conscious. When my turn came, I stayed focused on the task, went about the exam just as they had taught, and kept the conversation to a minimum. Overall, I felt the whole experience went pretty smoothly. But there were plenty of my fellow students who I’m sure were crippled with nervousness during their turn. You can imagine the quiet, academic, shy student who has avoided having to deal with breasts by hiding in books his whole life. Medical school has a few of those. I’d pay good money to see him perform a breast exam.
    So, the first of the awkward physical exam sessions was over. But the next would push the limits of uncomfortable encounters even further. Before our OBGYN rotation, we had to learn the female pelvic exam. I wasn’t quite sure how this was going to work. Maybe they had mannequins or detailed anatomic models for us to practice with. We were divided up into small groups once again, and were assigned to one teacher. Ours was a middle-aged woman who spoke very eloquently, and in a straight-forward and didactic fashion, told us all about how to insert the speculum. This tool resembles a duck’s closed bill, is inserted into the vagina, and then opened in order to view the cervix, which lies deep inside. We learned how to do a bimanual exam in which we feel for ovaries from inside the vagina. This was all very scary stuff. At the end of the teaching session, it was time to practice. Still, no mannequin in sight. She instructed us to step outside the room, and come in one at a time, and to pretend as if you were seeing an actual patient from beginning to end. She also said to give her a few minutes while she disrobed! Holy crap, we were going to be doing these pelvic exams on her! It was difficult to believe that someone would be willing to take on such a task. Each of the instructors must have had pretty strong beliefs in women’s health and education to put up with this. I made my way into the room when it was my turn, and fumbled through the exam. I constantly asked her if she was doing okay throughout, both as a way of avoiding awkward silences, and to try to convince both her, and probably myself, that I wasn’t nervous. In the end, the exam went fine, and there was a good deal of learning that came about as a result of the session. But there were still tons of questions floating around in my head regarding these instructors. One can’t help but wonder if they’re married and, if so, what their spouses think of this job. And how much does one get paid to be examined in this way by medical students? I’ll probably never know, but I do wonder.
    So, the tough exams were done, or so I thought. They saved the best for last. Rectal exams and the male genitals! Oh yes, there are groups of men who serve as teachers for these exams as well, and yes, we ended up performing the