Turn your head and cough
Yesterday I had the good fortune of helping out at a Preparticipation Physical Exam (PPE), or, as I like to call it, 'Yet another reason why ICM should be worth more than 2 credits.' The PPE is a way for area high school students to get screened quickly for any obvious abnormalities or conditions that might affect their participation in a sport. The fact that they permit second-year medical students to perform this screening speaks to the thoroughness (or lack thereof) of the exam. There's a room for head and neck, a room for cardiovascular and lungs, a room for the orthopedic exam, and a room for the abdomen and male GU exam. The students are shuttled through as quickly as possible, and accept their fate stoically, much as our old dog Annie accepted her baths.
The GU exam for the guys is as perfunctory as one can get. We were instructed to examine the boys' testicles to make sure that they had 2, and then to perform a bilateral inguinal hernia check, from which the title of this post is derived. Until last night, I had only performed this exam one other time, on a man who was paid $25 to let me examine his 'junk' and then stick my finger up his bottom. Needless to say, I was relieved when I was assigned to the head and neck room for the first portion of the evening.
I was fortunate to be paired up for this activity with my good friend Erik. At the beginning of our first year, Erik and I were assigned to the same gross anatomy group and have remained friends since, despite my constant whining during that course and my tendency to hand over all dissecting duties to him. His is the kind of brain that can bend spoons; as such, he is a good person to know when you have a question. (Although this can sometimes backfire, as he frequently goes way over my head in his explanations and mentions journal articles he has read on the topic at hand.)
While I would consider dropping out of medical school altogether if I had to repeat gross anatomy, I will acknowledge that it has value in medical education. If nothing else, it densensitizes one to the yucky stuff. Once you've dissected a human and / or had a kidney cyst pop all over you, your 'gross-out' threshold begins to rise. Soon, when you're looking at photos of a ring of genital warts surrounding a man's penis, or a fungus that has eaten through someone's face, it's no big deal. I personally appreciate it when truly spectacular images are presented in lectures or textbooks as they help me to remember diseases better. I like to picture our lecturing physicians, preparing their Power Points late into the night because they are looking for the most disgusting pictures they can find.
Bob and my sister have no appreciation for my morbid fascination with icky medical images. My suggestion to Kate that she should use her spare time to do a Google image search for 'goiter' or 'pyoderma gangrenosum' fell on deaf ears. Bob rarely appreciates it when I show him a good shot of an anal fistula or rare skin condition when we're studying together. However, much like the gross lab, I think that perusing the medical literature for 'interesting' photographs serves a purpose for future physicians. If you can handle scooping feces out of a dead person's rectum, or pictures of Mucormycosis, you can handle hernia inspections on high school students.
Which is what I did last night. At least thirty of them. Despite being put in the head and neck room for the first part of the evening, we were switched to the GU room later. By the second or third exam, I had lost all embarassment. "Drop your pants, please. This will only take a second," I'd tell the stoic football players. They may have been more comfortable if Erik had examined them, but that wasn't an option, as there were no gloves larger than size medium to be found. Since Erik is 6'4" tall and is normally proportioned, medium gloves didn't cut it for him.
I was proud of myself for my ability to be nonchalant throughout the whole experience (although, come to think of it, blogging about it hardly makes me seem like I have a casual attitude). Bob was fairly shocked when I told him what I had been doing for the past few hours, and then it dawned on him: "You're going to see a lot of penises in your career."
The GU exam for the guys is as perfunctory as one can get. We were instructed to examine the boys' testicles to make sure that they had 2, and then to perform a bilateral inguinal hernia check, from which the title of this post is derived. Until last night, I had only performed this exam one other time, on a man who was paid $25 to let me examine his 'junk' and then stick my finger up his bottom. Needless to say, I was relieved when I was assigned to the head and neck room for the first portion of the evening.
I was fortunate to be paired up for this activity with my good friend Erik. At the beginning of our first year, Erik and I were assigned to the same gross anatomy group and have remained friends since, despite my constant whining during that course and my tendency to hand over all dissecting duties to him. His is the kind of brain that can bend spoons; as such, he is a good person to know when you have a question. (Although this can sometimes backfire, as he frequently goes way over my head in his explanations and mentions journal articles he has read on the topic at hand.)
While I would consider dropping out of medical school altogether if I had to repeat gross anatomy, I will acknowledge that it has value in medical education. If nothing else, it densensitizes one to the yucky stuff. Once you've dissected a human and / or had a kidney cyst pop all over you, your 'gross-out' threshold begins to rise. Soon, when you're looking at photos of a ring of genital warts surrounding a man's penis, or a fungus that has eaten through someone's face, it's no big deal. I personally appreciate it when truly spectacular images are presented in lectures or textbooks as they help me to remember diseases better. I like to picture our lecturing physicians, preparing their Power Points late into the night because they are looking for the most disgusting pictures they can find.
Bob and my sister have no appreciation for my morbid fascination with icky medical images. My suggestion to Kate that she should use her spare time to do a Google image search for 'goiter' or 'pyoderma gangrenosum' fell on deaf ears. Bob rarely appreciates it when I show him a good shot of an anal fistula or rare skin condition when we're studying together. However, much like the gross lab, I think that perusing the medical literature for 'interesting' photographs serves a purpose for future physicians. If you can handle scooping feces out of a dead person's rectum, or pictures of Mucormycosis, you can handle hernia inspections on high school students.
Which is what I did last night. At least thirty of them. Despite being put in the head and neck room for the first part of the evening, we were switched to the GU room later. By the second or third exam, I had lost all embarassment. "Drop your pants, please. This will only take a second," I'd tell the stoic football players. They may have been more comfortable if Erik had examined them, but that wasn't an option, as there were no gloves larger than size medium to be found. Since Erik is 6'4" tall and is normally proportioned, medium gloves didn't cut it for him.
I was proud of myself for my ability to be nonchalant throughout the whole experience (although, come to think of it, blogging about it hardly makes me seem like I have a casual attitude). Bob was fairly shocked when I told him what I had been doing for the past few hours, and then it dawned on him: "You're going to see a lot of penises in your career."
