ICC year has been good so far. Stress levels are manageable and spike up only when I have pressing extra-curricular activities. I have ample amount of time to study and relax. My motivation to study is so I could perform a good interview and assessment of the patient and not because I would do poorly in a written exam. Very much unlike LU4. It's helpful that the consultants are very supportive and tolerant of our relative lack of knowledge.

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I also view this year as my year of redemption from ignorance of basic anatomy and disappearing knowledge of physiology and biochemistry. Finally, those anatomical landmarks are put into useful context and I wouldn't have to rely on rote memorization.

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Last week, I had another CEA worthy experience. CEA is a tool primarily utilized by Family Medicine specialists to handle psychosocial concerns of patients. CEA is an abbreviation of Catharsis, Education and Action. It works on the theory that talking about a problem helps solve it. I wasn't a great believer of this tool but the universe wants me to convert me and has put me into CEA patient encounters. Ironically, it is not during those sessions where we were expected to utilize CEA. The first one was during our musculoskeletal module in LU4 (2nd year) involving a patient with a fracture needing surgery. She's greatly troubled by her finances. I was interviewing her alone when she suddenly started crying. Hence, C of the CEA.

This time I was interviewing a patient again on my own as my groupmates were talking to the bantay. I was having a hard time getting a good history of the patient as she keeps going on about how she has no money, how she doesn't know why she needs another surgery and her desire to go home. I guess I should have read the  clues and started CEA but I have little time so I pushed for the obtaining the "pertinent" history. A seemingly innocuous question from her daughter whether she really wants the surgery or not opened a dam of emotions which frankly overwhelmed the shit out of me and my classmate (who was really an innocent bystander). Apparently, she feels abandoned by her family, fears that she will lose sight from her remaining good eye and feels betrayed by the PGH. I was put in a tight spot, I know that I can address at least one of her issues and allay her fear of becoming blind but I am not comfortable in interfering with the management of a patient who is not mine. In the end, I think she really did went home untreated and it's sad that her remaining years will be full of pain, anger and suffering.