Reflex Hammer
"Reflex Hammer" is a medical student.
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Education
Try your hand at a question from one of our anatomy exams. What nerve supplies the obturator internus muscle (a muscle in the pelvis)? The correct answer is the "nerve to obturator internus." It's like answering who is buried in…
Try your hand at a question from one of our anatomy exams.
What nerve supplies the obturator internus muscle (a muscle in the pelvis)?
The correct answer is the “nerve to obturator internus.” It’s like answering who is buried in Grant’s Tomb.
As a time-strapped medical student, it feels like a godsend when a medical term is named in an obvious way. Even a lay person can intuit the meaning of medical terms …
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Medical nomenclature is needlessly complex
Education
When listening with a stethoscope to a patient's heart, one sometimes hears a deviation from the typical "lub-dub" rhythm. Sometimes the "dub" is too loud, or the "lub" too soft. There might be a rubbing sound, or a harsh blowing…
When listening with a stethoscope to a patient’s heart, one sometimes hears a deviation from the typical “lub-dub” rhythm. Sometimes the “dub” is too loud, or the “lub” too soft. There might be a rubbing sound, or a harsh blowing sound. By interpreting subtle characteristics such as the location, pitch, and timing of these sounds, one can sometimes diagnose things like a diseased heart valve or congestive heart failure. …
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Medical students: Be sure to thank your patients
Education
A friend was working an overnight shift in the ER for one of her mandatory rotations, so I popped in to observe. The ER was surprisingly quiet. A classmate was also observing that night, and like me, he was standing…
A friend was working an overnight shift in the ER for one of her mandatory rotations, so I popped in to observe. The ER was surprisingly quiet. A classmate was also observing that night, and like me, he was standing around, bored. We spotted an electrocardiogram (EKG) readout lying on a desk where a resident was working, and we asked him …
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The strong tradition of mentorship is unique to medicine
Education
I attended a talk by the Dean of Admissions of one of the most competitive medical schools nationwide. The topic was primary care and community health. He talked at length about how not enough medical students were entering primary care.…
I attended a talk by the Dean of Admissions of one of the most competitive medical schools nationwide. The topic was primary care and community health. He talked at length about how not enough medical students were entering primary care. He put up some graphs showing that the most lucrative specialties tend to be the most competitive ones, with primary care among the lowest-paying and least-competitive. He said that medical …
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Medical schools don’t care about the primary care shortage
Conditions
Paradoxically, some parts of our body work best when they fail under stress. An illustrative story from my freshman year of college. I decided to buy a wheelie chair for my (miniscule) dorm room from a student who lived 1.5…
Paradoxically, some parts of our body work best when they fail under stress.
An illustrative story from my freshman year of college.
I decided to buy a wheelie chair for my (miniscule) dorm room from a student who lived 1.5 miles away. How could I transport the chair across campus when I didn’t have a car?
I didn’t feel like wasting an hour walking there and then walking the chair back. Instead, I …
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Useful design flaws explain some hemoglobin disorders
Education
Years ago, I spotted an acquaintance I hadn't seen in a while. The conversation was odd. A few times, I would ask a question and he would begin to respond, only to trail off into silence and stare blankly into…
Years ago, I spotted an acquaintance I hadn’t seen in a while. The conversation was odd. A few times, I would ask a question and he would begin to respond, only to trail off into silence and stare blankly into space. He would remain frozen until the moment I said something else, whereupon he would act normally. He seemed completely oblivious to the fact that he had trailed off and …
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Thought blocking and the privilege of becoming a doctor
Education
I recently learned the sorry news that my childhood pediatrician has died. Not only was he my pediatrician, but he was also my father's pediatrician. Our family became rather close to him over the years. He came from a different…
I recently learned the sorry news that my childhood pediatrician has died. Not only was he my pediatrician, but he was also my father’s pediatrician. Our family became rather close to him over the years.
He came from a different generation of doctors, one that made house calls, that served in wars abroad, and that learned how to diagnose patients in the days before MRIs and CT scans. Even though I …
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My pediatrician inspired me to become a physician
Education
I was skeptical when a doctor casually mentioned that 2% of all pregnancies are ectopic pregnancies (in which the fertilized egg is implanted somewhere other than the uterus, usually the fallopian tube). Without treatment, a common outcome is fallopian tube…
I was skeptical when a doctor casually mentioned that 2% of all pregnancies are ectopic pregnancies (in which the fertilized egg is implanted somewhere other than the uterus, usually the fallopian tube). Without treatment, a common outcome is fallopian tube rupture, which jeopardizes the life of the mother. It is a serious medical concern. I shot a confused look at a fellow first-year medical student. Two percent? It seemed way …
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Medicine involves a tension between isolation and connection
Conditions
There is a healthy debate over whether a lab that created an extremely infectious version of influenza ought to publish the genetic sequence. The debate speaks to a larger problem: sometimes, medical advances do the world a disservice. The medical…
There is a healthy debate over whether a lab that created an extremely infectious version of influenza ought to publish the genetic sequence. The debate speaks to a larger problem: sometimes, medical advances do the world a disservice. The medical field could use some soul-searching, just as physicists did in the wake of the Manhattan Project.
A few years ago, I read a neat research finding. In a pregnant woman, …
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When medical advances do the world a disservice
Education
Some medical schools have altered their admissions process by replacing the traditional applicant interview with the Multiple-Mini Interview (MMI). MMI resembles speed-dating: applicants rotate through numerous interview stations, where they act out scenarios and solve puzzles, sometimes alone and sometimes…
Some medical schools have altered their admissions process by replacing the traditional applicant interview with the Multiple-Mini Interview (MMI). MMI resembles speed-dating: applicants rotate through numerous interview stations, where they act out scenarios and solve puzzles, sometimes alone and sometimes in groups. A July New York Times article presented a good overview of MMI, as implemented by Virginia Tech Carillon.
As you might expect, schools that have adopted MMI (UCLA and …
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Problems with the Multiple-Mini Interview for medical school
Patients
The milestone of the world's population reaching 7 billion is a fitting time to reflect upon life expectancy. Life expectancy is a rough marker of humanity and medicine's progress in the age-old battle to attain old age. Those born in…
The milestone of the world’s population reaching 7 billion is a fitting time to reflect upon life expectancy. Life expectancy is a rough marker of humanity and medicine’s progress in the age-old battle to attain old age.
Those born in the US this year are expected to live until 78.37 years of age if current mortality rates persist. This puts us at a sobering 50th in the world.
How long is someone …
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Life expectancy is a simple number with immense ramifications
Patients
On July 24, 1998, a psychotic schizophrenic gunman entered a side entrance at the U.S. Capitol. As he approached Rep. John DeLay's office, he exchanged fire with two Capitol Police officers who later died of their wounds. The gunman was…
On July 24, 1998, a psychotic schizophrenic gunman entered a side entrance at the U.S. Capitol. As he approached Rep. John DeLay’s office, he exchanged fire with two Capitol Police officers who later died of their wounds. The gunman was badly wounded as well.
Senator Bill Frist, a cardiologist, was leaving the Capitol when Congressional aides informed him that some men needed urgent medical assistance.
A New York Times article tells …
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Non-judgmental regard can show the best of humanity
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