Post-Its or Breasts, I Can't Tell...

During breast surgery rotation, approximately half of our time was spent in the OR and the remaining half in clinic. Of the clinic time, about half was spent consulting or following up with patients who had demonstrably benign disease (that did not particularly warrant the time/expense of a breast surgeon, but whatever).

During the second half of this rotation, it just happened that the majority of the women I saw in consult had large breasts. Like...way large. Some of it was man-made, but most was god-given. And at first, I didn't know how to really present this information:

"Ms. ___ is 57y.o. and comes to us in consult from Dr. ___ after an abnormal mammogram that was rated as BIRADS 2 (translation: totally benign). She denies any breast symptoms inclusive of masses, change in breast size, constitutional symptoms, skin changes or discharge. She has no breast history. She took no oral contraceptives or hormone replacement. Menarche 12y.o., menopause 52y.o. She has had two babies with uneventful pregnancies. No breast trauma. No family history of breast or ovarian cancer. Otherwise insignificant medical, surgical history. She has never smoked, used alcohol or any other drugs. No allergies. No medications. On exam, her breasts are...(here's where I lost it)...copious...in the mammary tissue (100% true phrasing)...and are quite...smooth (also 100% true phrasing). No expressed discharge."

Internal monologue during this time: For god's sake STOP TALKING. 

Whilst delivering the history portion of this presentation, the doctor was signing paperwork. I was not watching him as I presented, but I heard him mutter that he needed a Post-It note. As I began the portion of my presentation regarding the physical exam, a nurse came in and delivered Post-It notes, but because I was looking at the chart, I did not register this detail. Thorough embarrassment ensued.

Me: (staring fixedly at my notes) "So on exam, the breasts are...uh...copious. So copious in fact that I  doubt the validity of my findings."
Him: "Sweet! We got big ones!"
Me: (still not looking up, thinking huh, that was kind of a weird response but resolving to just go with it) "Oh yeah. Yeah, pretty big. Seriously, I'm very impressed. So anyway...no appreciable masses, no retractions, dimpling or excoriation, no discharge..." and suddenly I realized that it was too quiet in the room, so I look up. He's staring at me, holding up a double-sized Post-It note.
Him: "Yeah. I was talking about the Post-It notes."
Me: (EFF!)  "Oh."
Him: (watches me inexpressively)
Me: "Um. Double sized Post-Its are nice; they have so much space." (yeah, I said that. *trails off, looks down in red-faced shame*)
Him: (nothing)
Me: "Uh. Should I start over?"
Him: "Yes."

There are two take-home points here:

1. God help me, I'll be a practicing physician in 120 days, and my communication skills and conversational intuition apparently have yet to exceed a level of sophistication greater than FINGERPAINTING. *facepalm*
2. Someday these roles will be reversed with some other unwitting/mildly retarded 4th year med student.