Free Clinic

Yesterday was my first clinical experience as a medical student. I spent five hours at a free clinic on Chicago's west side. The clinic is run by a nonprofit organization and is partially staffed by UIC volunteers (med students, residents, attendings) through a student organization. Anyway, the point is this was extracurricular to UIC's curriculum. UIC has some shadowing set up nine times throughout the year, but that's about it as far as clinical/patient contact goes. I just wish there were more chances to do stuff like this. Reason being, this stuff reminds me why I'm wading through insane amounts of facts and pathways. Being around patients again brought back why I'm doing all this and why it'll (hopefully) be worth it.

Anyway, as med students, the patients treated us as if we knew something. Scary things is, we don't really know anything at this point. Having said that, my having a reasonably heavy science background and decent clinical exposure made the whole experience so much better. Better in the sense that I understood some stuff that my higher-ups were talking about and kinda knew what was going on. Sure, it was all on a basic level, but it's more than some of my classmates can claim. Already having some idea of what's going on has me kinda excited...I might actually know what I'm doing in a few years. And that's just damn cool.

But even for those with less science and clinical experience, they had a lot of fun and enjoyed being around the clinic too. They got to see how some clinical aspects of medicine have ties to classes like physio and biochem. All around, it was a good experience for everyone. All the docs, residents, and med students were cool. No one was outrageously arrogant or anything like that - everyone was helping each other out and teaching whenever they could. That type of environment definitely made things a lot more enjoyable. I say that only because there are a few people in my class and probably a docs with whom I would not want to do a free clinic with. But, they probably wouldn't be in a free clinic anyway.

As for the actual patients, there was a good number of Spanish speaking ones. The dialog between the interpretor/med students and the patients was so fast, it was unbelievable. I was able to pick up bits and pieces, but a large portion of the conversation was obviously medically related. Since I don't have any exposure to that vocabulary or style of dialog, it made things that much harder to understand.

But, the patients were pretty cool in that they put up with having to see a lot of people over an extended period of time: an M1 and M2, then we bring in an M3/M4, and then the attending finally comes in with us. One patient can easily take over an hour to be seen. While this type of environment obviously kinda sucks for the patient, it's a pretty good learning environment. Especially for us M1s: we go in with the M2 and they do their thing, while teaching a bit here and there. Then an M3/M4 who's going through clinical rotations comes in with us: more teaching there. And repeat for when the attending comes in with us.

As for one patient, it was just a sad story. A Hispanic girl a little older than me came in complaining of shoulder, chest, and back pain. As the M2 and I are interviewing her, we find out that she's been having the pains for about a year and a half. She's been married for a year and a half and been in the country for two years. We ask if there's anything that sets off the pains, and she says that they happen when she's nervous and anxious. We present the case to the M3, and he comes in with us. Go through the story again, and focus a bit on the nervousness/anxiety. From her answers, we can tell something's up. We present to the attending and she comes in. After a few more focused questions on the anxiety, she breaks down and starts crying. She admits that her husband abuses her. The sad thing is that she's totally dependent on him - she's still in school and has no one else here. Just so sad how things can start out with general pains - then over the course of an hour pain is out of the picture and we find out about her husband.

This type of story wasn't an isolated one - another M1 had a similar patient. Another patient I saw was an alcoholic. If you were to look up alcoholic, you'd probably see his picture in the dictionary. He straight up admitted to drinking 2 liters of wine a day. But the reason he was in clinic was to check up on a blood pressure med switch. His other problems (blood pressure, prostate) were reasonably under control...not so much on the alcohol. I guess this type of demographic is expected at free clinics in big cities. I just hope that we were able to somewhat help them (even if I don't really know anything).

Even with it's low points, the free clinic was a nice break from all the book stuff. It was a nice reminder of why I got into this to begin with. Random clinical scenarios even reminded me that I'm actually absorbing some of this material. I might just be able to be one of those kids in the know and get to play doctor for real some day.