Yes folks. Last chance to touch the screen for healing for a week or so as I'm off to the sunny Aegean on hols for a week on Wednesday. Feel free to use this space to chat amongst yourselves whilst I'm gone. But before I go I have an observation and a question.
First the observation. Going on holiday can be a challenge. Mr Angry posted today about the profusion of "Doctors" with PhDs but not medical degrees. To be proper about it they have earned an academic title that dates back to antiquity and just refers to their learned wisdom. Thye have earned it and deserve to enjoy the benefits of their title. But I feel I must warn them that claiming it as an honourific comes at a price.
Before we had kids I could travel incognito as a "civil servant". Sounds just boring enough to kill all conversation and allow the repost "and what do you do?", deftly changing the subject avoiding any comeback. The thing is, even before I qualified any slip re my secret identity was an invite to the most excruciatingly embarrasing ordeal. Don't believe me...
Dr J (then undergrad' J) takes a job behind a bar somewhere in the Wild West Country over the hol's.
All is well for the first week. Then the Landlord's cousin (an hardened drinker) discovers from the Landlord the secret identity of the fledgling Doc. Cue the public display of the worldst most awful and awe inspiring hernia scar to the very loud if somewhat slurred accompaniment "Whaddaya fink a' that then Doc?" as he yanks his trews down to his ankles and pulls his not so tidy whities to one side. For the next two weeks yours truly was bombarded with questions about hysterectomies, gallstones, cystitis... you name it, I got it, often to similarly inappropriate visual displays. It was a relief to get back to Med School, so since then, on hols and in social settings with strangers you'll find mild mannered cub reporter (well civil servant in this case) Clark Kent standing in for Dr J.
Now we have kids I'm generally outed within the first couple of days, and again the discussion of subjects far better left to the privacy of the confessional resumes. Now don't feel that I'm complaining. I love what I do, and am generally more than happy to offer an opinion on just about anything, but it is nice to be off duty once in a while. Also it staggers me that on hearing that one little six letter word many people seem to shed all inhibitions to talk about and indeed on occasions to display bits of themselves they would never normally bring in to a polite conversation.
Which brings me to my question.
From time to time I am called upon to examine lady patients chests. Often, this can be safely limited to a brief application of a stethoscope to the back with clothing simply untucked and lifted. This I feel quite ok to handle in surgery as part of the normal routine, but sometimes, as today, a full examination in a state of undress is required. In accordance with current practice I no longer do these exams unaccompanied and so patient and I will move into the treatment room and sister will stand in as a chaperone throughout the exam. But, with a disrobed female patient laid on the couch, during the chest examination, where is it safe to look?
Over close inspection of the breasts sounds pretty obviously intrusive. Eye contact seems an equally obvious no no. Closed eyes is open to all sorts of misinterpretation (though I will often do this when trying to listen to chest sounds as I find it helps me to concentrate better -- whatever the age of gender of the patient before you go all funny).
So ladies, help me out here. What's a poor boy Doc to do?
Happy Holidays (well for me anyway). See you all next week.