Extern Miranda Ray @ London Women’s Care: Family Practice

                The externship in London, Kentucky with Dr. Zook has been extremely rewarding. Dr. Zook works at London Women’s Care: Family Practice. This is a well-established rural health care center. Rural health care centers are established with the intention of aiding persons with Medicare and Medicaid. These rural health clinics have extended hours and are very accepting and flexible with patient’s schedules and overall needs. London Women’s Care’s clientele is comprised a whopping 60% Medicare/ Medicaid insured persons. In short, these people that we have been interacting with are sometimes sweet Kentuckians with a warm accent and sometimes snappy and unappreciative, sometimes pensive and considerate of Dr. Zook’s advice while others are glazed over when they were given medical tips, sometimes they smelled like cinnamon or axe and sometimes, well, they smelled like cat pee.                        

               

As exemplified by the list above, during my time at London Women’s Care I was exposed to a variety of patients. I witnessed many techniques used to deal with difficult or abrasive situations. My, if you will, dream is to somehow work with and improve the lives of underprivileged folks. This Externship has thoroughly introduced me to a population I have been working towards caring for; I have been given an excellent jumping board for understanding the skills I need to develop to work with this population. I will speak of one example of a patient where I have learned a great deal about interviewing, understanding a patient’s physical needs, and helping with the patient’s emotional needs.

                The lady I will speak of was a relatively new patient, only on her second visit to London Women’s Care. Upon entering the room, we could see that she was noticeably shiny due to sweat, but let me assure you, the facility is quite cold. She was fiddling incessantly with a magazine to avoid eye contact after initial introductions. Dr. Zook chatted with the anxious woman for a bit and she calmed slightly. Dr. Zook then began to interview her asking simple questions that were friendly and inviting. At one point the lady commented on how sweaty she was due to her anxiety when she leaves the house. She mentioned repeatedly how difficult it was to leave her house to go to Walmart or go to a doctor’s appointment.  Dr. Zook mentioned social anxiety, and I, being inexperienced, just assumed that this was a diagnosis and Dr.Zook would not have ask many more questions, giving us a nice, short visit with a concrete conclusion. Then, Dr. Zook asked her a question that I found odd: “What are you afraid of when you step out of your house?” To my surprise, the woman became unsettled and looked away from us, turning pages of a magazine just to turn them. She was beginning to cry! After she settled a bit, she proceeded to tell us her amazing story. A story where we glimpsed the life of a seventeen year old marrying a boy, who quickly became an abusive and controlling man. He taped the doors when he left, so that he knew if she opened them, he tortured any pet she owned and dared her to save them, he installed cameras to monitor her daily movements, and he beat her severely if she returned after an amount of time he deemed too long. Oh, and he also placed a gun to her head every time she stepped outside to smoke (she had the babies to worry about), threatening to “blow her brains out. This and more was apart of 31 years of a psychologically shattering marriage. She finally ran away, but was left with serious emotional damage, including PTSD.  Her new diagnosis changed a lot of things in this woman’s life. She would be switched to new medication that would help alleviate her PTSD symptoms, she would be given the correct sleeping medication, she would start therapy to help heal the broken places in her heart and she would hopefully be able to leave the house and go hold her one month old grandbaby. These major changes in her life are occurring because of a few questions from a doctor who felt the need to find the root cause of a patient’s problem.

                Even in a visit with a single patient, I saw what I must work on to become an efficient and caring health professional. I have to get to the root cause of a patient’s problem with a gentle and eloquent style that reflects the degree to which I care.