Trust me...I'm a doctor (in training!!!)

I suspect that at this point in our careers, most med students are petrified at giving out medical advice when asked. This is a great thing of course, since like most med students I probably couldn't tell you the front end from the back end of an opthamoscope, much less give you cogent advice on your heart condition.

Inevitably, however, we do get asked. A couple weeks ago a friend of mine called nervously with the point blank question: "why is there blood in my stool?" Taking a moment to properly weigh the merit and urgency of the question, I wanted to yell back "OH MY GOD YOU HAVE COLON CANCER! That sounds horrible, have you visisted the emergency room?"

But I stopped myself. I mean, the words just didn't come out like that. Instead, I heard myself asking

"What have you eaten recently?"
"Do you feel sick/under the weather?"
"Can you tell me if it's dark brown/black or bright red?"
"For how long have you noticed it?"
"Are you on any blood thinner medication?"
"Was it hard/painful to pass stool? Was it loose or compact stool?"
"Does it hurt? Where?"

My voice slowed down as my tone deepened. I said things like 'uh huh', 'I see', and 'I understand' with every couple of sentences. I could see myself categorizing the information he was giving me and asking targeted questions to keep pace. I nodded my head as if he were able to see me.

After a while, I revealed that in class I ran across some common conditions that may cause blood to appear in stool. I told him what the research said, but that he should take everything I say with a huge grain of salt. However, I did tell him to make an appointment with his PCP asap. In the meantime, his best bet was keep making observations and bring a sample of stool to the doctors so they can analyze its content.

Somehow, I think the barage of information they keep on yelling at us in class is seeping in. At the very least, the method of questioning a patient for medical history, thinking logically and offering advice based on facts--they're all beginning to structure the way I think. It's exciting, and still very scary, but exciting nonetheless.