Pestilence

I haven't written in a while, but that's ok - nothing new of too much interest has been going on. I have come not to check in, but to whine and to complain.

I do not like microbiology, which is odd, because it's currently my highest grade. Beyond just not being enthralled with the subject, I feel that a large part of what we're being taught (at this very moment, actually) deals with details that doctors don't really care about. Do I need to know the diseases caused by Neisseria meningitidis, as well as the signs and symptoms? Of course! It causes meningitis, by the way, and it's got some interesting characteristics that dictate how you treat it - but I absolutely do not care what kind of agar medium it grows on. I don't care what color changes happen; nor do I care about the specifics of the tests that differentiate it from all of the other bacteria than cause infection. That's the job of the lab - I could be wrong, but I'm fairly certain that your average doc doesn't spend his time streaking agar and trying to grow plates of absolute pestilence. That's why there is a diagnostic laboratory. That's why you send off the samples - because it's someone else's job.

Truthfully, this isn't just because I dislike the subject - I admit that freely. It's that I like some of my time is being wasted on this; it's being taught because it's the pet project (by that I mean life's work) of the Ph.D who was hired to teach us. In the grand scheme of things, it's probably better to have too much detail rather than too little. If I had wanted that mind-numbing myriad minutia, I'd have gone the Ph.D route myself - but such is not the case. I have better things to do with my time than study how you run a microdilution automated system (something I will, i guarantee, mentally binge and purge like an unrepentant bulimic as soon as this test is over - unless it's on the Step, in which case I'll binge and purge again). One of those things is studying for the physical exam.

Over the course of the semester, we've had little workshops introducing us to the nuances of the physical examination - seemingly a lost art in today's culture of defensive medicine and space-age diagnostic imaging. The tasks in and of themselves are not difficult, but confusion creeps in when I'm trying to keep things straight - i.e. one should auscultate (listen) prior to palpation (feeling) in the abdomen, so as to avoid distortion of bowel sounds; or that the general survey should be performed at the beginning of the liver exam to search for possible concurrent jaundice - but not for the spleen exam (another story for another day - I've been doing little else other than studying what can go wrong with blood). It's enjoyable, if not a little bit awkward - feeling up folks always is. At least Nicole and I have each other - a significant other is a much better subject than a random stranger, especially when you have to do the kidney punch. I still have to practice, and I still have a lot to memorize, so that will be my task over the next few days. Several ironies are at work here: of all the things they're teaching us, this will probably be the one that I use the most for the rest of my practicing life, but it's it's got such a small point value right now, that I've heard some people simply don't show up. Also, even though I believe it to be incredibly important, I feel like it's a HUGE waste of my time right now - I'd rather be studying exactly how to run all those bacterial tests which I'll never run in real life, because those will be big points on the upcoming exams. Doesn't make any sense to me either - I just learn, purge, and hope that some of it sticks long enough (1) to help me on the Step and (2) to just maybe actually help me be of use to someone someday.