DON’T LOOK AWAY.
No matter how much of a shock it is, you must not flinch or avoid eye contact; the patient will have experienced a lot of this, so they will be watching closely to see how you react.
And this was the position I found myself in during our first primary care placement of Year 3. This week’s topic was Nasal Disorders and Neck Lumps, so we saw patients who had had nasal excisions or nasal polyps, and this was what led to the consultation with a patient who’d had a full excision.
I can honestly say that it was the most surreal thing I’ve ever been through/seen. When the nose came off, we could clearly see the nasal bone and the mucous in the cavity, and it was just like… whoa. I’m not even a squeamish person but it took all of my self control and professionalism to keep a straight face.
The patient was so so lovely; they had been through a lot, as getting used to the nose took them a while, but their attitude towards it all was really inspiring. What a start to third year, right? It really made me reflect on how far we’ve come from first year, and how much we’ve learnt about talking to patients, and putting them at ease.
This week also involved a nasal fracture and epistaxis management lecture, in which the lecturer turned up late because he fell over on his way to us, and broke his nose. The irony of it still makes me laugh as I type this. I then bumped into that same lecturer and his family later at the theatre that evening, and it turns out he’s a Pride and Prejudice fan too! He’s now my favourite ENT lecturer.