Last Week with FM Preceptor 1

After this week I will be reporting to a different Family Medicine doctor, but I will still be down the hall from the doctor I have been with these past four weeks.  I am going to miss her, as she was a lot of fun and very pleasant to work with.  She has a little arrangement of leafy plants in a basket, along with an ornamental bird nest containing eggs, and every time I looked at it I felt like it would be perfect to add a butterfly or two to the arrangement.  So, I brought in my box of extra collected insects and I wasn't expecting her to be in today, but she was and I gave her a small brown hopper butterfly and a medium-sized orange butterfly.  She was very thrilled, and said that she and her husband (one of the other doctors I am with sometimes) both like mounted insects (she likes butterflies, while he likes beetles) and that she couldn't wait to show her daughter the butterflies I gave her.  I wasn't expecting her to be quite so overjoyed, not to mention she kind of has a hippie-streak so I wasn't sure if she would be upset at the idea of killing living creatures, but it worked out great.  She and her husband remind me a lot of me and my boyfriend - both of us are interested in collecting natural things and travel - he collects Jade, she does underwater tropical photography, she also has a lot of plants and they like going hiking.  

Today I saw a few interesting things - one patient came in with textbook biceps tendonitis, I can diagnose that pretty easily.  One woman who came in actually had an ACL tear, so there was a significant amount of laxity when pushing her leg posteriorly.  I got to freeze off some seborrheic/actinic keratoses with liquid nitrogen, and the doctor showed me how much those procedures are typically billed (about $500 dollars just to spray 7 or 8 skin tags essentially, taking all of 5 minutes!).  When I get them I plan on just buying liquid nitrogen at the store and a box of Q-tips.  Another case came in where two elderly men arrived and the doctor told me in advance that the men are a gay couple, but because of the prohibitions on marriage the only way for one of them to stay in the country was for the older man to legally adopt the other one as his son.  How horrible is that?  Pretty ridiculous...  

Anyhow, still trying to work on my Herpes Zoster report - it's hard when you're so tired at the end of the day.    Some good news though - my preceptor's husband (the one who is associate dean of clinical education) and I were talking and eventually got onto the topic of preceptors and students and he openly said it would be a pleasure to write me a letter of recommendation at the end of this time.  He also looked over one of my SOAP notes and said it was 'excellent.  excellent note,' so in all, pretty decent day, minus the 3 hours of sleep...