Last Warren Village night

My fourth and last Warren Village session was this past Wednesday night. I've enjoyed pediatrics much more than I thought I would. I'm sad, though, because I will not be doing Warren Village next semester. The number slots is very limited, and I know that many of my classmates also want the opportunity to do this elective.

All four of my attending physicians at Warren Village have been fantastic: happy with their jobs, low-key, and eager to educate. They have also been very understanding of the fact that, in terms of medicine, I'm basically starting from scratch.

One of my patients on Wednesday was a teenage boy who complained of severe acne, mostly localized to his forehead but also spreading through his scalp. His mother was a "well-informed medical consumer" and wanted to know about more aggressive treatments for acne. On examination, though, this boy's skin looked exceptionally clear for complaining of severe acne.

When I presented this case to my attending, I made the rookie mistake of neglecting to mention that this boy also likes to use hair gel (a fact that came out while questioning Mom) but that he wasn't wearing any today. So, when the attending physician came in, he started working under the assumption that, like many other kids his age, he was just extremely sensitive to the self-image issues that accompany acne. Once the attending uncovered this hair gel issue, though, he soon concluded that this boy was suffering from dermititis as a reaction to the hair gel.

I felt stupid for forgetting to mention such a relevant piece of information, especially since acne typically doesn't even extend much past the hairline. But, the attending physician turned the mistake into a great learning experience. First, he provided an example of the type of questioning and investigation necessary to move past distractors and mis-information to get to the bottom of a presentation of symptoms. Second, afterward, he owned his own mistake of too quickly buying into the acne story instead of starting the examination tabula rasa.

This is the sort of experience that (I hope) will help me become a better doctor.