Clinical, Internal Medicine
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Big Nails on Examination Day

I love working as a resident physician, but I truly detest taking exams. However, life seems to only give you more of what you fear, so I recently found myself responsible for my residency program’s weekly clinical grand rounds — an exercise in which I would present a real live patient and be judged by my faculty and colleagues on my clinical acumen and physical exam skills. Passing would be a quiet victory; failing, on the other hand, would be a public humiliation.

My anxiety kicked in hard as the time for the presentation drew closer. As I rehearsed and revised just before the moment of truth, I was stricken with a revelation — I hadn’t cut my fingernails.

Alas, my personal grooming had become another casualty of my daily workload and brewing burnout. Ordinarily, this wouldn’t have been a concern, but here, my long fingernails would make percussion during the physical exam almost impossible. I would end up scratching, scarring, and bruising the patient’s poor abdomen with my taps earning a brutal shaming from my attendings in the process.

“Damn, I need a nail cutter, or I’ll fail,” I muttered under my breath, perhaps a little too loud. Cold beads of panicked sweat sprouted on my brow. At that moment, a general surgeon named Dr. S. who was seated in front of me in the lecture hall, turned to face me.

“Give me your nails — I will bite them down,” she deadpanned.

My reverie of impending doom broke. “Uh, what?!”

Placidly, she repeated. “We don’t have a nail cutter. Let me bite them off for you.”

A pregnant pause of consideration ended with an eruption of laughter, as the absurdity of the situation hit me. And just like that, my fear and anxiety dissipated, thanks to a well-timed dose of humor. I calmed down, and the presentation went smoothly — a testament to the power of a minor positive affirmation and the collegiality that so many of us residents depend on daily. I think back on this minor episode often when it feels like I’m just trying to keep my head above water.

And now, I keep my nails nice and trimmed.

Image sourcePatient examination table by Wonderlane licensed under CC BY 2.0.

Natasha Khalid, MD Natasha Khalid, MD (2 Posts)

Resident Physician Contributing Writer

Karachi, Pakistan

I work as a resident physician in Pakistan and have written on various mediums for over a decade now. Research and narrative medicine have always been my two major areas of interest and that have helped me channel my inner creativity alongside my mentally and physically exhausting work life. Outside my medicine life, I enjoy reading, traveling and running my blog: @natashablogs.