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I dare say if I hadn’t already known, I’m not sure I would ever. It was really amusing. We were out in 12 minutes  at.
I would not perceive this example of questionable behavior as amusing today. Overall, it was not a good educational experience and re ected the disdain with which female patients were held. The concept of women’s health had not yet been invented. The 3 weeks  nally came
to an end.
I am winding up Gynecology tomorrow. The highlights have been few – I picked up a case of trichomonas vaginalis almost by accident in the clinic the other day. I  nally saw what a contraceptive diaphragm looks like and learned how to insert one. I have seen various sorts of female problems, from frigidity to endometrial carcinoma. Today I saw ~ and diagnosed ~ Asherman’s Syndrome (intrauterine synechiae, and now for the  rst time Grade I hypertensive retinopathy. And I (this is a little ironic) had the opportunity to counsel a girl about to be married.
Even though I haven’t really learned a lot of procedures I think I have learned something about the Gynecological patient. But I think my time could have been more ef ciently and usefully spent. More OPD work is needed because here is where you learn to deal with the Gyn patient in the most important way, prophylaxis.
At this point,  ve months into the PCY, I began to get some feedback on my performance. The news was not good, and led too some existential self-examination.
I got a big, fat “C” in Medicine and a lot of comments about being super cial and incomplete, not living up to my potential. Interestingly, my student conference paper was highly praised, and almost everyone seems to think I’m not working up
to my potential.
I don’t really want to grasp at explanations. The
descriptions of me were true enough, though I think I was overly criticized for seeming lack of enthusiasm. There were a lot of things I didn’t do because I didn’t feel it was my place to do them. In maintaining a calm and somewhat detached
(I am told) exterior, I am open to the criticism of being blasé, but for heaven’s sake I just can’t look over-enthusiastic about every patient in front of everyone every day. I was under the impression that a certain amount of detachment was good – everyone else practices it (i.e., doctors), why not students?
In trying to approach things like a doctor, it appears I have n ot seemed to be suf ciently the student.
Anyway, I got a little depressed by I all. It is too late now to lose self-con dence in what I’m doing and where I’m going, and how I’m getting there. I just hope I’m right. But I feel I’m doing things right for myself and I can’t do them any other way. I do have to settle down and start some nitty-gritty reading – and soon – and maybe this will be the burr under my tail to make me do it. But I like going at my own speed and I hope I don’t have to change it.
Obstetrics at the Beth Israel was next.
1The plaza memorializes Oscar Tugo, who was the  rst enlisted man
to be killed by the enemy in WW I during an air raid on a base hospital in France.
2The BI is best known as the hospital made famous by Samuel Shem’s book, The House of God. The  ctional events in that book took place in the early 1970’s. The Beth Israel and New England Deaconess have since merged.
3A restaurant in downtown Boston famous for large portions, communal tables, and surly wait staff.
4A revered surgeon whom I had seen for a torn meniscus a year earlier; as I recall, he was the Harvard team physician
Ann Arbor State Bank 1/2 page vertical
Volume 70 • Number 3 Washtenaw County Medical Society BULLETIN 21

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