I Don't Know

As a medical student, I'm getting awfully used to uttering the phrase, "I don't know." I repeat it while studying, lament it when posed questions by professors and classmates, and hide behind it when asked for legitimate medical advice by friends and family.

At this point in my training, I'm just beginning to learn how to play doctor. Flubbing my way through the lines of the interview and pantomiming a crude physical exam when I see patients, I couldn't even pass as an understudy. Yet, by virtue of my white coat and stethoscope, sick individuals lying on stretchers occasionally confuse me for an actual physician.

It's still a little exciting, and always humbling, when that happens. A mini ego boost to be sure, but canceled out when patients actually expect me to know something. Like the woman who grabbed my hand, looked me in the eye, and fearfully asked, "Do you think my cancer will come back?"

My initial reaction was a flash of terror. I wanted to stammer that I'm doing my best to learn at least 75% of the material before each exam, and feel like I'm struggling to retain even a quarter of that information the week after. My charade had been exposed - I was soliciting details without any idea of what to do with the information, and possessed no ability to respond to questions asked of me in return.

So, I told the truth.

"I don't know," I confessed, still holding her hand, "but the doctors are going to do everything they can to make sure it doesn't."

How Times Have Changed

College: Standing in line at Walgreens buying red plastic cups and ping pong balls at 10pm on a Saturday night.

Med school: Standing in that same line in sweatpants and flip flops buying a box of Cheerios.

Med School at the Movies

Sometimes, it seems, you can only memorize so many muscles that sound like Harry Potter spells (Extensor digitorum!) before taking a break from the anatomy atlas and popping in a DVD.

Unfortunately, one side effect of medical school appears to be constant reminders of things we've studied. Using The Princess Bride as a study aid? Inconceivable, you might say. But consider the following examples of high-yield medical miscellany...

Polydactyly: The six-fingered man who killed Inigo Montoya's father. He likely suffered from an autosomal dominant condition.

Acromegaly: Fezzik's great size stems from an excess of growth hormone production by the pituitary gland.

Reversible injury: As Miracle Max points out, "Mostly dead is slightly alive." Perhaps Wesley's hepatocytes simply needed time to regenerate.

Hypertrophy: R.O.U.S. = Rodents of Unusual Size.

Feel free to use this helpful study guide as you wish.

For All You EMS Types...

(To borrow a phrase from Ambulance Driver)

Esquire profiles a paramedic trainee's introduction into the unique world of emergency medicine. Hat tip to a friend for passing the article along.

Meanwhile, if anyone out there still reads this, I'm hoping to share some med school/ER stories soon.

Extreme EM

Two of my favorite things... emergency medicine and running. Great article about brining emergency care to marathon runners in New York this past weekend.