Today was the first day of my 3 weeks of outpatient internal medicine. Some people refer to it as Ambulatory Medicine. Maybe that’s because the patients, for the most part, walk in.

I was putting on my shoes on the way to the 7:30 AM orientation session when I noticed a text message on my phone. It was from a classmate. It read, “Where are you?”

It was 7:15. Plenty of time for me to get to the hospital for the orientation. But with the text, I realized my mea culpa. It was a 7:00 AM orientation.

But what can you do? Whoops. So I strolled in to the conference room 30 minutes late and took a seat.

And that was my entrance into Ambulatory Medicine. It was a fitting start to the day. Because for the rest of the day I felt a little bit lost. Ok, fine. I felt a whole lot lost. Whether it was what to do with the patient after I had finished up with them, or where to send them when my attending wanted a STAT X-ray, I was totally in the dark.

A number of times I walked to the friendliest looking nurse and asked what I was supposed to do. What do I do with this chart? This patient is ready to go, do I just send them outside?

I saw a total of three patients today. None of them were terribly complicated patients. Their problems were manageable. But the situation was uncomfortable — for me.

But when it was all said and done, it was nice to have seen the patients. The population at a VA is a unique one. I remember one elderly patient who was in the US Army Airborne back in his day. Served 3 tours of active duty. He also showed me pieces of shrapnel under his skin that were still just coming up to the surface some 30 years after his injuries.

Crazy day. A day that started with a “whoops” and was filled with almost a constant sense of being lost. But it was a good day.

Even as a medical student, one meets and interacts with enough patients that it is difficult to keep the details of their lives straight. But if there are two things that you should remember about each patient before seeing them, it is their name and their number. And by number, I don’t mean their digits.

Most patients are pretty reasonable about understanding that people in the hospital or clinic deal with so many patients that they don’t care if you forget the name of their dog or their third cousin’s limping poodle. They do, though, at least hope that you can remember their name when you walk into their room. After all, when entering a room, one often does have access to the patient’s chart. So putting in the little effort it takes to get the name correct is something everyone appreciates — even the little ones.

I remember one time when I was on my Pediatrics rotation. I was on the In-Patient portion of the rotation, which means I was seeing patients who were admitted to the hospital and were staying there for their treatment. As is the custom of many a medical student, my white coat pockets were filled with papers. One of them had the name and room number of the patient I was going in to see.

I glanced at the name and room number and started off to see the patient. I’ll call him Joey. Joey had been in the hospital for about half a week and I had seen him every morning at around 7 AM. This day, however, I was in a hurry. I needed to see him and do a quick check and then get over to a morning meeting. My mind was racing about the things I needed to do after my visit.

“Hey Chris,” I said as I walked in. Joey looked at me silently. There was no correction. Perhaps he didn’t have time to correct me. I quickly corrected myself and said “Joey.” But the damage had been done.

He wasn’t as happy as usual during my visit that morning. This was probably due to the fact that he was medically worse that day than the day before. But I can’t help but think that the fact that someone totally forgot his name played some part in him not even smiling during that visit.

I felt bad about my mistake. I don’t do much as a medical student. The most I could have done was to get my patient’s name right. All I needed to do was to look at my sheet as I was walking in the room. It probably won’t be the last time I slip up like this and say the wrong name. But now, because of Joey, I pause before entering a room to make sure I read the name correctly.

The second fact about a person that I think one should remember is their age. A 53 year old woman might be happy when you say that she is 43, but it does her no good for you to treat her as a 43 year old. The screening and prevention that a 53 year old needs is different than the screening and prevention a 43 year old would need. Knowing someone’s age is not just a nice thing to do, it helps in their care.

There was one time when I was doing a complete physical for a young man. As I got to his social history I asked him about his smoking, alcohol and drug use. He denied all three. Never smoked. Never did drugs. When I asked about alcohol he said no at first. But then admitted to having some alcohol a couple months ago. And it was at home, he added.

I was really confused. It seemed like there was some guilt in this admission. Most people I asked freely admitted to drinking multiple drinks on the weekend. I wondered if there was some sort of problem. After all, guilt about alcohol use is one of the things used to screen for alcohol abuse. I considered pressing the issue further to investigate the possibility.

Then I realized the guy was under 21 — the legal drinking age. He was slow to admit one drink a couple months ago because he shouldn’t have any legal means of obtaining alcohol in California. If I had remembered his age, I would have known that the guilt I perceived was not because he was having an alcohol abuse problem, but because he had just admitted to being a minor who had one drink. At home. A few months ago.

So the next time you enter a room, just sing to yourself, “What’s your name? What’s your number?” And it’ll all be easy from there — hopefully.