The Mental Status Exam and obsolete ethernet cables

I’ve written the neuro exam, the respiratory exam, the cardiac exam? (not yet) – what else. Pelvic exam will certainly deserve something. Anything that intimate. Eye exam (except I’m not good at it/we don’t really learn a good one, in med school). Musculoskeletal could be interesting.

Dermatologic, again, we don’t really learn, but that sort of scrutiny to the outside might be the most similar to psychiatry’s scrutiny of outside-to-inside-to-outside.

It’s applicable to anything. In psychiatry, actually, I did a presentation on the mental status exam and interpreting poetry – poetry I blurred on the projector screen so that you couldn’t read the words.

Mental status includes action, includes movement and speech and anything that indicates internal state in externalization.

I spend a lot of time, lately, searching for wi-fi.

Crossing into Chad

The Procedure

(This was written several weeks ago – refers to all month of July)

Today I used sound waves and a plastic transducer to take moving photos of a fetus-squiggle. I was outside, it was inside, and now it doesn’t take long for me to find the uterus, to see the black-filled-collapsible bladder on top of the double-stripe collapsible uterus that now, in pregnancy, isn’t so collapsible (potential space). The black-fill is water, and there’s a tiny yolk sac (depending) and there’s a little squiggle (this early). And it turns and turns and turns on a stalk, and I have to move, patient, to capture it. Length-wise. Freeze. I measure. My machine converts that to weeks.

And I print the photo, attach it to the woman’s chart on which I’ve written LMP/Gs and Ps/prior c-section or surgery. Bleeding or pain? Prior ultrasound?

I’ve filled in provider (the attending), the clinic, the date, and the patient’s name, DOB, medical record number are stamped at the top of the carbon-copy page. White copy on top.

I write in the length I found (if it’s first trimester-early, it’s crown-rump length - descriptive, no?) and I write it in mm and I write the gestational age.

I mark: + IUP.  + FCM

Single, intra-uterine pregnancy

Fetal cardiac motion

Under “reason for exam” I write “dating – undesired pregnancy.”

The Luckiest

It’s said in many ways.

Absence makes the heart grow fonder.

Nostalgia in looking back.

Selective memory.

And, per Ben Folds, “The Luckiest.”

This usually refers to, I think, people/place/thing. Certainly people. Certainly place. Time period. Self at a different stage of life.

It’s not usually used in reference to career.

It’s now been three days since I was an active medical student.

And I miss it. A significant lot.

I can’t wait to be a doctor.

Kribi, Cameroun