Vital signs

It’s the fourth day of class, second day of real class (i.e. not orientation) and I’m sitting like an eager puppy in the second row of our Intro to Physical Diagnosis lecture. I have my pens in place, my laptop out, and I’m ready to go. Our professor poses the question, “How many of you took vital signs as part of your previous job duties? A sea of hands stretches to the ceiling.” So she asks, “Perhaps a better question would be, how many of you didn’t take vital signs?” My lonely hand reticently rises a few inches above my shoulder. “Oh shit. What have I gotten myself into?”

You see, I came from the world of human and social services, where we talked about patient advocacy, health equity, social (in)justice and conducted half-hour prevention counseling sessions. I ran a program working to make rapid HIV tests available to anyone who wanted one. My clinical hours racked up by performing HIV tests, delivering diagnoses, collecting samples for STD screens and drawing blood for syphilis screens.

But vital signs?! I got into PA school without ever taking someone’s blood pressure? I felt like a fool. So I called on my courage and reminded myself why I applied to PA school in the first place: The field of medicine needs more people like me. We are the ones that deal with people at their emotional worst. We work through people’s shame about who they are and we fight stigma at every corner. We try and understand the complexities behind why people do the things they do. We are health workers that serve anyone and everyone.

Luckily, a new friend pointed out, “At least you won’t learn the wrong way.” And she was right. I may have fumbled with the blood pressure cuff and put my stethoscope on backwards (apparently the little ear pieces should face forward), but I learned how you should do it. I wasn’t shamed for my ineptitude. My classmates helped me out, and as our professor wisely said, “How can you expect to be good at something if you’ve never done it before?”

Flash forward a few weeks. We’re going over obtaining patient histories, how to talk to patients … you know, bedside manner stuff. We had an exercise where we had to tell a patient that the lump in their breast was cancerous. We took a report from the pathology lab and explained it to a patient. Fighting my fears of looking stupid, I volunteered to do a role-play with our professor in front of the whole class. I wasn’t perfect by any means, but it was the first time I felt semi-confident about doing something.

After class a few people approached me and commended me on my ability to counsel patients. “I wouldn’t have even known where to start,” said one of them. Our program staff tells us we were all picked for a reason, to teach one another and to learn from each other. So maybe this was part of why I was picked. I can inject my previous role of social service guy into the world of medicine. Perhaps patient counseling is a skill just as valuable as a lumbar puncture.

I’m not saying I don’t ever doubt how/why I ended up here. There are definitely days where I yearn for my previous non-profit life. And although it’s hard, and distant, I try and remind myself of the bigger picture: One day, I’m going to be a PA who knows patients, can hone in on their struggles/worries and can allow them to feel comfortable enough to tell you the real reason why they came in today. And to me, that may be the most important vital sign of all.

2 responses to “Vital signs

  1. Joseph, I very much agree that, “patient counseling is a skill just as valuable as a lumbar puncture.” Thanks for sharing your perspective!

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