At the heart of medicine lies the proposition "everything in moderation." A core premise of every aspect of practice, from pharmacology to preventative medicine, homeostasis (our fancy word for balance) is what keeps you going.
Excess is the enemy, a destabilizing force that introduces openings for all of our natural enemies. Even natural acts like sex can be intrinsically damaging (beyond the potential for spread of disease). Honeymoon cystitis is a bladder infection induced by bruising damage to the bladder from repeated or forceful sex. Yes. We named it honeymoon cystitis.
These days, the honeymoon isn't actually the main source of this cystitis. As times changed, and the honeymoon and loss of virginity have diverged, a more experienced population has managed to avoid the pratfalls of their elders. But the name has stuck, an institutionalized giggle at the expense of a population that is enjoying themselves far too much.
Saturday, April 3, 2010
Friday, April 2, 2010
Oddly Physical
The medical student white coat is too small for me. Tight across the shoulders, short at the wrist, It manages to hang yet cling, simultaneously wrinkled yet tight. It exists as a sartorial metaphor, a reminder that, as of now, the role of the physician doesn't quite fit.
In this capacity it works perfectly, as I only wear my white coat when pretending to be a physician for the purposes of my higher education. Each time I see a patient (even our pretend patients), I gird myself in the uniform of a pseudophysician. I walk into a room, alone, expected to comport myself in a manner suitable to my profession. I walk into a room, ill fitting coat a palpable reminder of my inadequacy, and try, against all common sense, to act as a physician should act.
I perform physicals for training. Real patients, real physicals, fake doctors. It is a surreal moment, running through the physical on the other side of the examination table. 25 years of experience as a patient, 25 years of reflex hammers and the ubiquitous "turn your head and cough." We give our doctor a trust, an understanding that they can violate the extensive rules governing touching in modern society. We do so because they have training, they have impartiality. They have professional dignity that they worked obscene hours and years to obtain. They have done all of this before, and seen all of it before.
I have none of these things. My training is, as of now, mostly scientific, not practical. But every doctor had to learn these things, had to do it and see it the first time. These patients volunteer me a trust I have yet to earn, a right to perform the tasks of a true physician. I take them up on this trust, poking and prodding their bodies, focusing on the science, wrapping myself up in an ill-fitting aura of professionalism. I do the work of a physician, learning and improving, until the day I can get a better white coat.
In this capacity it works perfectly, as I only wear my white coat when pretending to be a physician for the purposes of my higher education. Each time I see a patient (even our pretend patients), I gird myself in the uniform of a pseudophysician. I walk into a room, alone, expected to comport myself in a manner suitable to my profession. I walk into a room, ill fitting coat a palpable reminder of my inadequacy, and try, against all common sense, to act as a physician should act.
I perform physicals for training. Real patients, real physicals, fake doctors. It is a surreal moment, running through the physical on the other side of the examination table. 25 years of experience as a patient, 25 years of reflex hammers and the ubiquitous "turn your head and cough." We give our doctor a trust, an understanding that they can violate the extensive rules governing touching in modern society. We do so because they have training, they have impartiality. They have professional dignity that they worked obscene hours and years to obtain. They have done all of this before, and seen all of it before.
I have none of these things. My training is, as of now, mostly scientific, not practical. But every doctor had to learn these things, had to do it and see it the first time. These patients volunteer me a trust I have yet to earn, a right to perform the tasks of a true physician. I take them up on this trust, poking and prodding their bodies, focusing on the science, wrapping myself up in an ill-fitting aura of professionalism. I do the work of a physician, learning and improving, until the day I can get a better white coat.
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