Seeing Is Believing
I bring this up because I observed a rather interesting event on my second day of inpatient internal medicine this afternoon, one that really makes me wonder whether I've actually been right all along in my as-yet-incomplete and poorly thought out theory that...well...medicine is bullshit, and succeeding in a medical field is all about who can bullshit the best and convince everyone else that their bullshit is cleaner than yours. Don't get me wrong, medicine (and I'm speaking broadly here, so not just internal medicine) has obviously done billions of wonders for prolonging people's lives blah blah blah, but while I can't really describe what I mean in words just yet (as this is something still formulating in my mind), I know what I mean. I hope that is vague enough for you.
Anyways, our chief resident gathered me and the other four medical students rotating through internal medicine at a specific hospital and conducted the first of our physical diagnosis rounds, where we are introduced to patients with interesting physical findings on exam and then have to figure out what's going on, with chief resident guidance and teaching along the way. In other words, this is the part where we ignore that whole "a patient is a human being to be respected with privacy" crap and instead adopt the "a patient is part of a circus freakshow and must be displayed, poked, and prodded by as many people as possible in as open of an arena as can be found" philosophy of patient care, where not even my dreamy blue eyes and soothingly sexual voice can put a patient at ease. I actually enjoy these rounds, because sometimes I...brace yourselves...learn something. Really, I swear.
After seeing a few patients, she asked any of us if we had patients with interesting findings that the group could check out, and one of my colleagues (who I must admit is one of the rare medical students I genuinely respect, mainly because he's almost as big a jackass as I am) recommended one of his patients, ultimately proving that if one learns nothing else in medical school (and believe me, most don't), it's that one should never, ever volunteer for anything. Ever. He described a malar rash we were supposed to see, and we went in to see the patient. The chief did an exam and started pointing out a rash she was outlining with her finger on this lady's face. Now, I didn't see a damn thing other than a big bandage over her right eye that was placed there after her eye surgery that morning, but if you refer to the first sentence of this post, you'll find that this sort of thing happens to me all the time and I just did what I normally do and kept my mouth shut. Also, being at the absolute bottom of the totem pole means you speak your mind when it does not come at the cost of embarrassing your superiors, so I've gotten pretty used to this scenario. We talked some more about the rash, look at it for a little while longer, and then walked out.
It's at that point that my friend (obviously feeling as stupid as I felt at not seeing what should have been a textbook rash) looked at his notes, smiled like the jackass that he is, and said, "Oh, umm, so ya the patient we were supposed to see was actually in the other bed." Which means we saw the wrong patient. Which means the patient we saw did not have the disease we thought she had. Which means there was no rash. Which means the chief, drawing on four years of clinical experience, essentially willed into an existence shared only by her imagination a rash that was in fact not there, never was there, and likely would never be there. Which means the chief tried to teach us and show us a rash that never existed, and we (sort of) believed it and were ready to learn from it.
In other words, medicine is bullshit.
Now, it's obviously ridiculous to draw that conclusion based solely on one example, but I just thought I'd describe this scenario because a) it actually happened, b) it probably happens all the time, and c) I really think I might be on to something here, as I'm wondering how much of medicine is really just a product of one's imagination versus how much is rooted in actual science, fact, and reason. In other words, how much of medicine is geared towards the patient, and how much is really only for our own peace of mind? After all, if someone can will a figment of one's imagination to appear on the face of another person, how much more can one imagine? A diagnosis that is wrong? A cure when there is in actuality no hope? I'm clearly not even sure where I am going with this, but hopefully you get a sense of what I mean, and if not, I'll try better next time.
Oh, I should also add d) it reminded me, yet again, to never volunteer for anything.
(And in case you are counting, I made five direct references to excrement in this post. Hi Mom!)