Tuesday, February 8, 2011
I know you've all had the experience of sitting in class and thinking to yourself, "I'll never use this is real life".  For most people, that happened some time in Algebra.  For me, and a lot of my classmates, it happened sometime during microbiology and immunology.  We sat there thinking, "Why does it matter if this is a lactose fermenting rod or a beta hemolytic cocci??  This is why they have UpToDate!"  And while it does seem like we are forced to shove a lot of "useless" information into our brains, there is value in it.

I mean, all information can be looked up somewhere.  So what's the point in learning at all?  Well, looking up information takes time.  And understanding what it means taken time.  And then knowing how to use it to figure out what you want to know takes time also.  And when someone is dying, or sick, or you are seeing them in a 15 minute appointment, you don't have time to look it up.  You have to know.  That is why we go to medical school, and that's why seeing a doctor and looking up something on WebMd are not equivalent. 

Take for instance, a situation I was talking to a friend about.  She happened to find herself in an ambulance with a man who was sick.  He had a fever, and was acting kind of funny, and his lungs sounded kind of junky.  That's all she knew. 

What would you think about know that much information? 

Well, here's how our conversation went.

Me:  Was he old?
Her:  No, middle age.
Me:  Other health problems?
Her:  Nope, generally healthy.
Me:  Huh, strange.
Her: Yeah.  The paramedic asked me if I'd seen anyone act this loopy because of a fever.
Me:  How high was his fever?
Her:  Only to 103.  I don't think that was it.
Me:  Huh.  This is suspicious.
Her:  Yeah.  We put on masks.
Me:  Did he look like a meningitis guy?
Her:  Maybe.  We put on masks.
Me:  Good call.
Her:  They said in the ED they might not do a spinal tap.  I hope they do.
Me:  I hope so too.  Maybe they will treat first.
Her:  But I want to know what it is!
Me:  I imagine you do!
Her:  Looks like they got blood cultures and treated.  I want to know what the culture shows!
Me:  Strep pneumo is the most common cause of bacterial meningitis, right?
Her:  Yep.  I hope it's not meningococcus.
Me:  Me too.  The gram stain will come back soon.  Looks like they're already treating with Vanc and Rocephin.
Her:  It's a gram negative diplococci, right?
Me:  I think so.
Her:  I wonder if they'll prophylax without a positive culture.
Me:  Huh.  I dunno.  You should tell them you want some Rifampin if they think there's a chance.
Her:  Then I'll cry orange tears.
Me:  Cool, huh?

Okay, so that conversation was SLIGHTLY embellished (really, only slightly).  The point is, we went from "I saw this dude on an ambulance" to talking about the likely bacteria, what it'll show up as on a test, how to treat him, what else it could be, and how to prophylax contacts, in about 3 minutes.  You could google "funny acting guy with fever", and eventually you might figure out that he could have meningitis.  Then, if you knew it was important, you could look up what bacteria might cause it, and what they'd look like under a microscope.  But it would take a LONG time. 

The fact of the matter is, no regular non-medical person walking down the street needs to have this information tucked in their brain.  But even though I didn't think I'd ever need to know which bacteria are gram negative rods, it's useful. 

And even though you didn't think you'd ever use algebra again, you will. 

Trust me. 


About Me

I am a Family Medicine intern at a community hospital in Indiana, navigating the new world of being a physician. I am privileged to work in a field I love, where every day is a new and unpredictable challenge.
I am not only a doctor, but also a cyclist, runner, DIYer in the making, lover of the outdoors, traveler, and human.
Human, MD is a glimpse into the world of a young doctor who is just trying to stay true to herself through the grueling whirlwind of residency.


Visitor Count