Stories from training

 My learners seem to get a kick out of my misadventures in training, and as I age I forget more stories. Maybe it's time to start writing them down.

You know how they tell you to make patients show you how they use their puffers? Precovid world? 

Yeah. Do. A patient admitted for recurrent COPD with a significant language barrier showed us - his very confused care team (his treatment is maximized! Why is he flaring?) - how he uses his puffers.

Spritz spritz x3 into the air in front of him. Then he leaned forward and took a deep inhale through his nose. Maybe one step above people who are satirized to use puffers like perfume.

Us: "..........oh" 

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Speaking of language barriers: I once saw a lovely Chinese patient who spoke a little Mandarin, a lot of Cantonese. Her friend/interpreter spoke a little of English and a lot of Cantonese. I speak a little of Mandarin and a lot of English. So it went in a 3 way circle of me saying something in Mandarin or English, the two of them translating for each other, then each giving me half a sentence. 

I misplaced the word for "bladder" in Mandarin. As if I ever knew it. I told her the problem was her "plastic bag that holds urine". She was understandably confused. 

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One would like to think those who are multilingual sympathize with others who speak English as a second language. A preceptor and excellent physician who is of Brazilian origin turned to me and asked if I could speak to a patient who only spoke Vietnamese.

"I speak as much Vietnamese as you do?"

"Oh you don't speak 'Asian'?"

"...do you speak 'South American'?" 

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A delightful preceptor, probably in his young 40s at the time (he seemed so old then! Now I think he's pretty young) called me into his office one day. His office is very small, holds two people, and has no window. He closed and locked the door as I went in, and I thought for sure he was going to rip me apart for a patient or chew me out on a case and fail me on the rotation. 

He looked gravelly at me then asked, "so what exactly is a Dank Meme?"

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