ANTOINETTE: The OPEX Experience

Hey everyone!  I wanted to use this entry to share a little bit about my OPEX clinic.  (Note: OPEX = Outpatient Experience).  Regardless of where you end up for medical school, you will have lots of opportunities to practice in-patient care during rotations on the wards, but I am so grateful that Emory’s new curriculum includes a year-long component where we are assigned to a primary care out-patient clinic during our 1st semester.  The clinics are spread throughout the greater Atlanta area and serve different patient populations (insured vs uninsured, family medicine vs internal medicine vs pediatrics, etc).  Everyone comes to Emory Med with a different story, resulting in a depth and breadth of firsthand clinical experience with patients.  I had worked in free clinics but now, donning my white coat, patients expected me to know something. 

I volunteered to be placed at Grady’s International Medical Clinic (IMC), where most of the patients don’t speak English and many are uninsured.  While I’ve taken Spanish since middle school and have lived abroad in Spanish-speaking countries twice, I’m not as confident as I would like with my language proficiency.  I figured this would be a great way to get over my Spanish jitters and work with an underserved population, which is where I envision my career to be in the future.  Two Thursdays out of the month, I take the shuttle into the city and shadow senior internal medicine residents, who run the Thursday afternoon  clinic and report each patient to an attending.  It gives me a chance to touch patients and practice my new-learned physical exam skills.  But it also provides an early look into continuity of care. 

I have seen Mr. L. three times since October 2007.  He’s a jolly Jamaican with well-controlled diabetes and hypertension.  I was shocked to learn that he was in his late 70s as he doesn’t look a day over 50.  By the second visit, Mr. L. was greeting me with a crushing handshake and hearty bear hug.  I saw him alone and planned to present him to the resident myself.  As I took his vital signs and gathered his chief complaint and history of present illness for that visit, he regaled me with stories from his heyday when he boxed off knife-wielding thugs, and not-so-subtly hinted that he had a son my age. He didn’t believe me when I told him I was “only a first year med student” and made me feel like I was a part of his medical team, even when I got his blood pressure off by 10mmHg. 

Mr. L., an English-speaker, was the first patient I saw by myself, but since then, I’ve been able to see Spanish-speaking patients on my own each time I’m in clinic.  It’s great to translate things I’ve learned to the clinical setting: listening to pleural effusions during the pulmonary module, observing as a patient was diagnosed with guttate psoriasis during the dermatology/rheumatology module.  OPEX is a wonderful reprieve from the grind of classwork and lectures, and the admissions folks are not kidding when they say students have real clinical experience as early as our M1 year.  When we get to the wards in March, no one will be caught like a deer-in-headlights when they have to touch and talk to a patient.  They should have been doing it for a year already. 

over and out scout,
Antoinette

PEARL: A Vacation in Your Own City

Three of my best friends from undergrad visited me from Chicago this weekend. I love to have visitors – it’s a great excuse to take a vacation in your own city and do all the fun things you’ve been meaning to do for ages. Since Meg, Rada, and Karyl arrived in Atlanta late on Friday night, we relaxed the first night, running out to the 24-hour Kroger in my neighborhood to pick up some essential snacks – goat cheese, corn muffins, baby carrots, cheap frozen pizza, Champagne, and orange juice. This is where we first met Engelbert – a thank-you gift from my guests:

He is, in fact, even more fabulous than these pictures can express. And – I must admit – a little bit frightening. I’m still jumping a little bit every time I walk into my room and see him on my bed, but I’m sure that will ease up with time.

Saturday morning, we all woke up early and trekked over to the Highland Bakery for breakfast (http://www.highlandbakery.com/). Highland Bakery is a great brunch spot –you can walk in, put your name in for a table, grab a cup of coffee and a paper, and head to their back waiting area to sit and read the paper while you wait for a table. I think the best way to describe their food is that it’s good – the ricotta pancakes are light but delicious and the crabcake benedict is unusual …but delicious. The restaurant space is full with a great energy of happy people eating fantastic food without being cramped or crowded. When you’re in Atlanta, this is definitely a place to check out.

After breakfast, we rolled our stuffed selves out of the restaurant and headed down to Zoo Atlanta (http://www.zooatlanta.org/home.htm) to walk off breakfast and see the baby panda. It’s a nice zoo, with elephants, meerkats, lions, gorillas, and lots of other exotic animals. We went to the petting zoo, bought too-expensive kitsch at the gift store, and got super cool panda tattoos:

After a full day, we headed to Joe’s Coffee Shop (http://atlanta.citysearch.com/profile/35878675).  Joe’s is in East Atlanta, my neighborhood, about five miles south of Emory. East Atlanta is very fun and funky – according to one review, it’s the “epitome of cool,” where anything and everything goes (http://atlanta.creativeloafing.com/gyrobase/Content?oid=oid%3A18645). Joe’s is the neighborhood coffee shop, with excellent coffee, a desk, and very rich cupcakes. I’ve spent many hours studying anatomy in that coffee shop, which certainly leads to some interesting conversations as folks walk by and see me studying pictures of dissected cadavers. Rada, Meg, Karyl, and I grabbed a giant couch and did some dramatic readings from Creole Caress – a romance novel we picked up from the local bookstore (http://www.boundtobereadbooks.com/).

After relaxing in the afternoon shopping in Little 5 Points (another great neighborhood you can read about here – http://www.l5p.com/), we toured the Emory campus and then got dinner at Saba in Emory Village (nice pasta place within walking distance of school – I like the pumpkin ravioli and the spaghetti bolognese – http://www.saba-restaurant.com/). We headed back to my house, where we re-grouped and got ready to go out.

We met up with friends from school and went dancing at MJQ, a club that is literally underground and nearly impossible to find if you don’t know where you’re going – above ground, it is literally a shack. It was a great place to actually dance, though, with two good D.J.’s running two floors and people from all walks of life who just want to dance.

After a long day, we returned home to crash. Unfortunately, my girls had to leave early this morning, but I think they (and you, vicariously), got a pretty good slice of Atlanta life. Now, it’s time to study hard. We’re in the middle of our pulmonary module, which is definitely ramping up on the intensity, but very interesting because the lungs are kind of critical (that whole oxygen dependence problem…) and a site for a lot of infections and pathology. We’ve got two weeks to the exam, which means the entire class will be stepping up the studying to get ready. Until next time… the very best to you and yours!