Sunday, February 21, 2010

Polar Plunge and more

Hi all,

Life has been far busier for me this semester. This is due in large part to my getting involved with a number of new projects, a few of which I will tell you about. Overall though, life is good

The biggest news is I became a part of the MEDiC council for the rest of this year and into next. What does this mean? Well, the MEDiC coucil consists of UW health sciences students (mainly med) who work together to run 6 clinics in Madison for uninsured people seeking acute medical care. We can't offer extensive services/followup but we can deal with more mundane issues and we also have numerous connections around Madison to refer our patients too. My specific role is as a clinic co-coodinator for one of the 6 clinics. The clinic I am based at runs every saturday 8-1pm and we see a large number of Spanish speaking patients. The basic premise is that students in teams of two interview and examine patients to the best of their ability before reporting to an attending physician. They then come up with a treatment plan and all go back in to discuss options with the patient. As a coordinator I make sure all the students and docs show up, orient everyone, help connect patients with referrals, write up a report, and trouble shoot the many unforeseen events that always seem to come up. I have been training for the past month and should start on my own come some time next month. In some regards the position is similar to my role as a patient navigator in Americorps but I do less direct service in this position and more enabling of others to serve. So far it has been great!

On the physical side of things I have been training for a 50K cross country ski race. The date for this is next Saturday and I couldn't be more excited. My goal at this point is to finish before they call the race. Never having skied of any sort until this season the learning curve has been steep but I feel more or less ready:)

Another endeavor has been planning out events for this summer. On the agenda so far is spending a week in northern WI working with a rural family doc, assisting several communities in Jalisco, Mexico with a variety of community wellness projects for 4-6 weeks, and co-leading a team of UW health sciences students and doctors to run medical caravans in a remote part of Guatemala through a partnership with a local mission for two weeks. More on all those in the future.

As alluded to in the email I sent out I also participated in a Polar Plunge to raise money for special olympics in WI. Please see pics below. In total friends and family helped me to raise $225; the highest total on my team - thank you to all who donated!

(Our med school team - Dr. Bucky's Hyperthermics. the name was supposed to be a joke, hyperthermic means very warm which is exactly what we were not:)

(We had been standing out in line, waiting to jump, for a good 15 minutes at this point and were pretty well chilled. I was jumping up and down to try and stay warm. It was snowing a bit too but luckily not real windy. For anyone wondering, the shape on my left chest was meant to be a rough outline of where we learned our hearts are.)

(Jumping. The hole in the ice had been cleared out away from the shore so we had to walk around, jump in, swim a bit and then clamber out on some stairs they had put in.)

(The feeling can only be described as instant numbness of all body peripheral tissue. And massive cremaster muscle action. I was the first one out of the water which meant I was also the first one in the...)

( Or, rather, luke-warm tub, but it was way better than the lake!)

(Our team after.)

Switching topics, I recently wrote a short piece on an experience I had while working in clinic. It was for submission to an annually published compilation called "Chicken Soup for the UW Medical Student Soul" and I have pasted it in below for anyone interested.

YAWNING - Michael Wauters, M1

“Hey Michael, this looks like a good one for you. Forty-six-year-old Latino man complaining of frequent urination and testicular pain.”

I was at GPP, the acronym for generalist partners program, where first and second year medical students get an introduction to clinical medicine through the opportunity to work with a local general practitioner once or twice a month.

I glanced at my watch before entering the room, it was getting towards 7pm, the end of our evening clinic, this would be our last patient and I was ready to get home and get some food. My GPP introduced me, as is his style, checking that the patient was OK with talking to a student first.

As I sat down on the stool across from the man, Ricardo we will call him, he tried to stifle a yawn with limited success. I inquired what had brought him to the clinic and he replied in short phrases. A minute passed and there was another suppressed yawn. Why was he so tired? After 5 or 10 minutes I had run out of questions I thought applicable but something just seemed off with his manner. Another yawn escaped.

“How many hours have you been sleeping per night on average?” I inquired.
“Five,” came the quick reply
“Do you feel that is sufficient for you?” I asked.
“No.” A brief silence ensued.
“And what is causing you to only get 5 hours of sleep?”
“My wife has died.”

I was not expecting to hear this. This man was in his forties. I wondered for a second if perhaps my Spanish had failed me and I had misunderstood. I asked again to clarify but there had been no misunderstanding, his partner was gone. I offered condolences. They seemed to lie there on the floor, squirming around, not quite adequate, not really reaching Ricardo. I felt torn between asking more and not wanting to stab into a wound I could see was hurting him profoundly. I had never been in this situation before. I took a middle road, not asking directly about his wife’s passing but how he is coping, what life is like now. I found out he was having trouble keeping it all together with no real support system in Madison and two high school age daughters to care for. He was still reticent in response. I inquired if he had been able to talk with someone about what had happened; he had not. Nor did he want to talk to our clinic psychologist.

I left the room to present the case. Frequent urination, no change in hunger, etc… and, his wife died a few weeks back. My doc was as stunned as I was. Then he added some bad news to mine. Blood work he had ordered on a hunch was back and the results were not good, an elevated blood sugar sufficiently high to diagnose Ricardo as diabetic.

The doctor and I returned to the room. Upon further questioning we found out Ricardo’s wife had passed away from swine flu. At this admission, he began to cry, trying to hide it some, until that became useless. We tried our best to console him and offered again the opportunity to talk with people at the clinic. He declined once more. After talking about his wife’s passing, we then had to inform him he was diabetic. It just didn’t seem fair; this man was already suffering enough. His initial reaction was incredulity; he didn’t believe us. The doctor had to repeat himself. We explained the basics and figured out a plan for Ricardo to return for follow-up care. However, it would be almost a month before he could see the diabetic educator. I stayed in the room after the doctor had left to explain a little more about what diabetes is and some of the basic nutritional steps he could start with to help improve his health given his newly diagnosed chronic condition.

After the visit, as I watched him walk down the empty clinic hallway, I could only imagine the pain and loneliness he was feeling. Reflecting back, I honestly wonder how much help we had been that evening. But then I envision, what if he had not come to clinic at all? His body would have continued to ail from the diabetes and he would have not had a chance to let out what had been on his mind night and day. It’s true, he declined further help, but I hope a seed was planted, that he knows there are other people who care about him, who are willing to help when he is ready. As a first year medical student my ability to diagnosis disease or design a treatment plan is almost nil. However, that evening with Ricardo reminded me that I do have something to offer, something that we all have, the ability to care about others.

I still think about Ricardo often and I hope he is healing, inside and out.