Wednesday, September 28, 2011

Guess Mess



The principle that has medicine as an art, in my mind, is what marries the science with the guessing. There have been numerous times in the past few months where we've been told that practicing medicine is really just an investigation that one needs to proceed with to try and arrive at the junction of making a diagnosis with the most information possible. What seems strange to me (or perhaps, felt strange to me) is putting this in the terms of diagnosis being nothing more than a "best guess." Maybe it is the terminology. As I learned the hard way yesterday with a quiz I mis-studied for, the language of medicine is often just renaming principles and structures we already are familiar with, with terms that are often (literally) Greek to me.

Had I tried to articulate this idea prior to entering medical school, I could've probably come up with this, but as I've learned over and over, for me, ideas often take awhile to manifest in realization and/or action. I think there was, and may still be, a part of me that holds the idea of being a doctor on a plain that allows for instant knowledge retrieval from an infinite reservoir. While this is clearly ridiculous, there is something to be said for having the largest possible knowledge accumulation possible, as being able to come up with the initial differential in one's mind is quite an advantage. This of course, is scope of practice dependent and complicated internal medicine cases and the like should always be cross-referenced via resources, including texts but also other physicians.

Here is to being the best guesser I can be.

Sometimes all I can think of when "guessing" is discussed in a lecture is the movie "The Jerk" with Steve Martin which has him working as a "weight guesser" during his time with the Carnival. And that's the only thing I need -- is this book. I don't need this or this. Just this laptop... And this note-card. - The laptop and the book and that's all I need... And this stethoscope. - The book, the laptop, and the stethoscope, and that's all I need... And these scrubs. - The book, and these scrubs, and the stethoscope, and the laptop... And this highlighter. - The book, this stethoscope, and the laptop, and the highlighter, and that's all I need. And that's all I need too. I don't need one other thing, not one... I need this. - The laptop and the book, and the highlighter, and the scrubs for sure. Well what are you looking at? What do you think I'm some kind of a jerk or something! - And this. That's all I need.

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