neuroclutter

The week after a test is always a little light on classwork. I really spoiled myself - I got to work out 5 days in a row - something I've never done down here on the island. I even took a long run along the mountainous roads that loop in and out, giving peek-a-boo glances of the Caribbean sea.

We had our first test of the semester a week ago, and this one was overwhelming. I came out on top, but this was the first time I was really floored by how much we have to know. That was before the actual exam. Afterwards, I was struck by how much stuff I've crammed into my head at this point. After something like 34 official medical school tests, I'm starting to feel like I know stuff. As I've said before, though, we're starting to move to a more practice-oriented learning process, beginning to leave behind our basic sciences years. That being the case, I know lots of stuff, but I know how to do very little.

Nicole and I are fond of watching the Discovery Channel's Mystery Diagnosis. Unless it's some incredibly rare condition that only a handful of doctors even know about, we generally find ourselves struck by the fact that no one figured it out sooner; if we know the answer, why didn't anyone else? It could just be artful editing directed at the diagnosis, but more often than not, I find myself wondering why no one [on the show] is running an MRI on someone with frightening neurological signs. Let me remind you, however, that I may feel like I know a lot, but I know how to do very little.

Perhaps I should clarify that - I can do cardiovascular, respiratory, abdominal, and certain general exams; I can cut into the body and find any organ, vessel, or nerve that has a name; I can do several different kinds of suture. I do not, however, know all of the heart murmurs - I only know a few; I do not know how to do neurological exams - though I will have practiced by the end of this week; I do not know how to administer medication, or dosing - but I can name literally hundreds of drugs and tell you how they work. So far, my learning has been foundational, and while I enjoy looking at pathology slides of gallbladder cancer (bad choice of example...it's not that interesting-looking, but it was on the tip of my tongue), it's the doing; the practice that is the heart of medicine. So I don't really know anything, I guess.

Yet.