Chronicles of a Student-Doctor #2

CHAPTER 2: ENT (EAR, NOSE & THROAT) POSTING

Welcome to Otolaryngology (also called Otorhinolaryngology) department.

More than anyone else, we are concerned about what happens to your Ear, Nose and Throat. This is because we understand how those relatively unimportant parts of the human body can cause such great discomfort whenever something is out of place. You can count on us to do all we can to help you get better.

(Image-credit: WEB)

I resumed to ENT clinic with little or no knowledge about what it actually involved, asides Ear infections. Well, I had an unfortunate episode of Otitis Externa (Outer Ear Infection) few months after I got into medical school. Initially, I thought it was no big deal and I could manage by myself until the pain became so unbearable that I couldn’t even attend classes. I had no choice but to see a Doctor. Of course, the relief I got after some days of treatment (with antibiotics and corticosteroids) was priceless. I’ve never since taken my ears for granted.

My experience in ENT was great. Not only did I learn more about that specialty of medicine, I was also able to pick up some valuable life-lessons as well.

We had outpatient clinic on Tuesdays and Surgery on Thursdays. My amiable Preceptor, Dr. Thomas, had a private practice as well, and we went there every other day in the week.

 

(Photo-credit: WEB)

 

After my first few days, I got the hang of using an OTOSCOPE and stating my differentials based on what I saw inside a patient’s ears.

 

(Photo-credit: WEB)

 

I also learnt how to perform the Weber and Rinne tests (to check for conductive or sensorineural hearing loss) with the aid of a tuning fork.

Youtube link. (All Access Medicine)
Most of the patients were student-friendly, so I clerked a good number of them.

 

(Photo-credit: WEB)

 

In the clinic, a typical day is spent examining, listening to, reassuring, prescribing medications and giving patients bits of advice about their health. The Doctor would always caution the patients against using Q-tips (cotton buds) in removing excess wax from their ear canals; but advised them to make use of drops of olive oil (or hydrogen peroxide), to soften the hardened wax, thereby facilitating its removal by the Doctor himself. (Yeah, we saw lots of wax-impacted ears and it was unbelievably gross). Impacted earwax can be superimposed with bacterial infection, so if you have an ear discharge that gives off an offensive smell or your ear itches you repeatedly, please see a doctor. 

 

(Image-credit: WEB)

 

Soon enough, all the forms of Otitis (Externa, Media and Interna), Tinnitus, Allergic Rhinitis, Acute Bronchitis, Vertigo, Nystagmus, Hyper/Hypothyroidism, GERD, Sinusitis etc, became common terms and relatively easy diagnoses for me to make.
Some surgical procedures I saw were: Tonsillectomy,  Turbinate reduction, Bilateral Antral Wash-out (BAWO), Lingual frenectomy, Thyroidectomy and Tracheostomy.

 

TEAM ENT (Preceptor flanked by some Ortho Students)

 

The Ortho folks in X-ray protective Gears.
On a particular clinic day, I got to watch the Audiometric technicians at work. It was an insightful experience.

Audiometry is the science of measuring hearing acuity, with the help of an audiometer. Results of audiometric tests are used to diagnose hearing loss or certain diseases of the ear” (WIKI).

 

(Photo-credit: WEB)

 

While most of the cases were mild, I remember a devastating case in particular, a patient presented with advanced-stage Oropharyngeal cancer. What really struck me however was my Preceptor’s display of Empathy; Despite the strong offensive odor coming from the patient’s mouth, which we all (including the nursing staff) found repulsive, the Doctor actually went ahead to touch the patient and speak words of comfort to him, without as much as a nose-mask. He taught us an important life-lesson that day, everyone needs someone to show them some care, no matter how hopeless the situation seems.


Another highlight for me, was when we had the opportunity to accompany our preceptor to give a lecture in one of the other medical schools on the island. That was my first time there and I had a great experience. I also had the opportunity of seeing some parts of the island I wasn’t familiar with.
Towards the end of my posting, the Preceptor also took us to an all-expense paid lunch in one of Vincy’s finest restaurants. And we had so much fun that I wish we didn’t have to leave.

 

(Photo-credit: http://www.panoramio.com)

Image: Cobblestone Inn, Kingstown, SVG (free advert, lol).
Then the icing on the cake for me was when he shared with us that in considering a choice of specialty, each of us should ask ourselves these basic questions:

1. What area of medicine do I like? (Interest)


2. What area of medicine am I good at? (Strength)


3. What area of medicine is needed in my immediate environment? (Need)

I have since kept these thoughts and pondered over them. I know they would come handy sometime in the near future.

***
So would I like to specialize in ENT? Your guess is as good as mine, I’d rather not. Maybe it’s because of the thought of doing surgeries…hehe, no thank you!

By the way, please note that these commonly used drugs can be toxic to your ears. Always consult your Physician for concerns about side-effects of the medications you use.
Thank you for reading!

:::Requ1ne:::


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