Day 2 of Scoping in Clinical Interlude

"I would not give that liquid to my dog. I just want to eat," said Mr. B during rounds. He was referring to the liquid diet that is given to patients about to undergo a GI procedure, such as an upper endoscopy to explore for any evidence of ulcers that are bleeding.

When we spoke with our last patient today, he was frustrated and unable to comprehend why the doctors had to keep him in the hospital and keep performing test after test to explain why his lab tests were indicating he had lost half his blood volume.

In our last day of interlude, we started with grand rounds at 8 AM. Sitting in a lecture hall, we listened to a talk about celiac disease for the first hour followed by another lecture about the liver and genetics (the content completely surpassed my comprehension).

Once we arrived at the VAMC, we joined Dr. M. We met our first patient to get his consent for the colonoscopy. There are a few risks involved with any procedure. The major risks include bleeding, perforation, and anesthesia-related complications on the heart and lungs.

After consenting two patients, we observed a colonscopy and an upper endoscopy. We also observed an ERCP (Endoscopic Retrograde Cholangiopancreatography), which uses a combination of X-rays and endoscopy to visualize the pancreas and gallbladder, along with the biliary duct system. Before entering the patient room, we were given these heavy leaded vests to protect us from the X-rays.

In our second day of interlude, we felt a bit more at ease. When we walked with Dr. M from the GI unit to the ICU, I felt like I was actually jogging to keep up with him. But we felt like we were part of the team when we rounded on the in-patient consults. And today, I also listened to our patent's lungs and hearts, and got to learn about their histories and stories.

I walk away from interlude with a picture of what my third year rotation (and subsequent years in medicine) will look like. Dr. M was a fantastic mentor. He included us on his team and made an effort to teach us. I look forward to wait awaits us in the years to come.

Image: "ERCP." http://www.gehealthcare.com/usen/xr/surgery/images/ercp2_500.jpg