Our clerkship director has a nice catch phrase that sums up the medical student experience pretty well: “You have one foot in the medical world, and one foot in the real world.” By this, she means that as medical students we’re not completely totally 100% sucked into the crazy world of medical jargon, probabilities, and doctor-think. And because of this, we’re a valuable asset to our teams; we’re able to spend more time with our patients and our families, and we often act as translators from Medicalese to English (or Spanish, as the case may be).
I’ve always prided myself on being very perceptive of the medical jargon, and I’ll even go so far as to interrupt my attending to translate if necessary–but I’m losing my touch. Because the Pediatric patients are pretty quick and to the point, I can usually do a pretty quick presentation. But between trying to improve my speed and translating for most of the past two weeks into Spanish, my brain hasn’t had enough processing power–I caught myself asking an English-speaking patient if her child has been “afebrile,” and got a confused stare immediately. “Uh, I mean, has she had a fever!?” I asked apologetically.
And yesterday, more evidence that my medical training is starting to influence the things I assume: a 6-year girl came in for a red streak (mom thought it was blood) around her stool, and going through my history with the mom, she said that cancer ran in the family. I ignored the fact–didn’t even present it to the attending–no way cancer is relevant to this case. My astute attending, however, asked mom: “Any intestinal problems in the family?” and the mother replied, “Yes, my grandma just died of intestine cancer, and it started with blood in her poop.” Of course! No wonder the mother is coming in–she had assumed her child might have colon cancer. Me, medical student that knows that colon cancer in a 6 year-old would be extremely, extremely, extremely rare (as well as most other cancers), just skipped over the fact, assuming that cancer had no role in this case.* (It did have a role–but psychological, not medical.)
The deeper down the rabbit hole you go, it seems the harder it is to even know your assumptions. Until you get burned. All of a sudden they become much more apparent.
* I know someone is going to comment about FAP or HNPCC or ulcerative colitis, and how those could have a child presenting with colon cancer. I know, I know.