The director of our Ambulatory Medicine clerkship loves to show this graph to try to put our medical education into perspective (or better, show its severe lack of perspective): if you take 1,000 people, 750 will have some ache or pain or medical problem, 200 of that 750 will actually seek a doctor for advice, even fewer will be admitted to a hospital, and even fewer will be referred to an academic medical center (that’s my patient population, mostly). So should I, or you, really be surprised that today was the first day I’ve seen a patient with a cold?
Probably… not. In fact, colds, flus, and sore throats were my probably main personal exposure to physicians as far as my own health went. But I’ve focused so much on the things that medical professionals consider common (lower back pain, right upper quadrant abdominal pain, hypertension, diabetes, dyslipidemia) that I had a few seconds of deer-in-the-headlights when my patient came in today complaining of “feeling terrible” and having a runny nose, stuffed up nose, and cough. Had I taken a step back to my own personal experience to think “what other problems did I have when I had her symptoms,” I probably would have done even better.
I almost get the feeling that I’ve become less comfortable with my own experience and gut instinct as I’ve been working my way through clinics. There are just enough treatments that are somewhat counter-intuitive on first glance that I’ll sometimes hesitate on what I would have been sure (and correct) about even before I started medical school. So my gut has been torn down, and will be rebuilt as gut-of-physican (another reason I’m dreading graduation; have you noticed your physician’s stomach lately?).
But luckily my mind’s still powered for faster-than-Google medical searches. Give it a few seconds to warm up, remind it of the category of information the patient requires (“antibiotics for sinusitis and bronchitis,” “common bacteria causing sinusitis,” “anatomy and drainage of maxillary sinus”), and it kicks into action. It’s pretty damn amazing.
(Oh, and just for anyone who doesn’t know this, I’m currently wowed with the transdermal sinus illumination trick. Next time you’ve come down with a sinus infection on one side, put a flashlight against your cheekbone–that’s the zygomatic arch–near your nose, and point it toward your mouth. The clogged sinus won’t show any light, but the clear one should shine the light into your mouth.)