Saturday, September 15, 2012

What the Heck is Going On Here?

I'm having a few thoughts this morning, so I'll share them.

Class is going very well. We have a good group of people, both students and instructors, and I'm enjoying this very much, and looking forward to hanging out with these folks for the best part of a year.

I've found a very useful resource for the class. An obvious one.
The text we're using has an associated website, with lots of study-stuff. Some is more useful; other stuff somewhat less.
I've been taking advantage of the "flashcards" they have set up for each chapter.
After going through them a couple of times, I realized that they are set up to match exactly with the vocabulary list.

Memorization is not, in general, the best tool for learning. It provides no context, and that means much of it will be remembered short term, but not long term. I'm going for long term.

So if the flashcards were FACTS, I think they would be less useful.
But they aren't facts.
They are LANGUAGE.

Perhaps you have noticed that your language, the vocabulary you frequently use, has changed somewhat since becoming involved in EMS. We talk about stuff that no normal (read: "not an EMT") person talks about.

Being comfortable with the language helps to avert those "I know what it is, what it does, and why it is important, but I just can't remember what it's called" moments. More than that, it brings the medical field into daily thoughts, rather than something in a class, on a test, or during a call.

One of the things that knowing the language has helped me do is be an advocate for friends and family who are having some sort of medical experience. This is not a small thing.

Have you ever noticed that the average person has no understanding whatsoever of hospitals or medical conditions? I thought so. They often don't know what is happening, or why. Mostly, they ALSO don't really care to know all the details past "this is going to make me (or a loved one) better so we can get out of here."

I don't know about you, but I have found friends and family to be fabulous sources of medical education. I have also found that it's better if I don't mention this to them directly. The person having the A-fib typically does not find the monitor NEARLY as interesting as I do. The person just out of brain surgery has no actual interest in knowing about the effects of intracranial pressure.

If it's a situation where I have fairly direct access to the medical staff, it works well to have them explain to me what the situation is and what they plan to do about it, and I can make sure it is understood by the patient. I tend to know what questions to ask, and can explain procedures and options. I have found hospital staff very open to this, and willing to provide more accurate, less "dumbed down" information, once they realize I understand what they say.

If I don't have access to the medical personnel, it gets even more interesting. I get to play the "what the heck is going on here?" game. There is great challenge to be found in taking what the average layperson says about a medical situation, and figuring out what is really going on. Especially in the early stages of diagnosis, when no one really knows yet, in the investigative stage. Tests, descriptions, differential diagnoses- these are all rich with the potential of a layperson getting things very confused.

I once had a distant family member describe someone's condition as "she has a wiggly thing in her head." Hmmm. Where to go with that?

I find that I'm pretty insatiably curious about all the various ways a body can fail to function correctly. There is no end that I've ever found. It's no wonder doctors specialize- there are simply too many variations out there for anyone to be well versed in all of them.

I get to specialize in "whatever odd conditions find their way into my awareness" through my friends, family and patients. I look them up. Any time I hear about some medical condition I haven't dealt with before, I create my own "crash course" in whatever that is. Google is the most amazing thing. I can no longer fathom trying to learn about things without it.

I learned a lot of cardiac stuff when my father had an arrhythmia. I've had patients with spinal abnormalities, very rare kinds of cancer, rare diseases named after some combination of people with fascinating combinations of signs and symptoms. Right now, I have an acquaintance recently diagnosed with an unusual type of non-malignant brain tumor.

All of these are not only opportunities to learn about the condition, but to learn about how people respond when they discover they have a serious disease. The whole mental/emotional process is as important as the physical process, and often overlooked. I find this aspect as compelling as the physical part. It's probably where I can actually provide the most help to someone, rather than any of the technical skills I can perform. It's unfortunate that there is so little focus or training provided for this.

Then again, if we were experts on everything, an EMT class would take approximately a zillion years to complete. In essence, it does. Anyone who thinks their learning is complete when they pass the final test, is missing the point entirely. Anyone who thinks a class can "cover" everything we need to know hasn't spent much time in the field.

It's a fascinating world out there.

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