Palpitations give me palpitations.

Monday was my first clinical exam, my first chance to show off my skills gathering a chief complaint, medical history, family history, and social and cultural history from an actor-patient, while being observed and recorded on camera by my preceptor.

Mr. Johnson presented with a feeling like his "heart was just going to jump out of" his chest. That's a pretty good description of palpitations, which is a tough symptom. Like chest pain, it can be so many different things- from anxiety to a life-threatening heart attack!

And what do I do? I proceed to go through the whole gamut of questions. Besides the medical and family histories, I also have to ask things like, "Do you consider yourself a spiritual person?" or "Are you sexually satisfied?" (I forgot to ask this one, BTW).

I know that these are all learning experiences, and one day it will be important to ask those questions, but sometimes it feels funny to move on from palpitations to spirituality, and then on to sexual satisfaction.