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| Image Credit: Flickr |
Author: Thomas Hull, MSIV
Loyola University Chicago SSOM
I remember trying to take my first history and physical as a first-year medical student when a middle-aged man came into the emergency department (ED) with transient ischemic attack-like symptoms. With the encouragement of my preceptor, who was the attending emergency physician, I went to do a full interview history and physical. After spending almost 45 minutes learning about this man and his life in friendly conversation, I exited the room to see my preceptor with a somber face. The patient’s head computed tomography revealed numerous scattered round tumors at the gray-white junction, likely metastases from melanoma, which I’d just heard had been treated years ago and he considered “past” medical history. My preceptor apologized for such a first encounter, though confessed she was relieved to have a partner in delivering the news. I welcomed the role, willing to employ whatever emotional capital I’d just established, and confidently planted myself at his bedside as she began to tell him. But when he started crying, I knew that there was no good response – I stood there speechless.
