Wednesday, July 9, 2008

Fair Weather Ahead

There are certain truths concerning medicine that are kept from the general lay public for the public health benefit. Mostly their peace of mind -- not so much their actual morbidity and mortality. One of these truths is that July is the best time to be killed by your doctor. Ninety-nine percent of residencies begin in July and all the fresh new interns -- most of whom know less than they did than as even fresher third year medical students -- combined with fresh new senior residents -- who were themselves only a year ago fresh new interns -- mean that the chances of you getting worse from your hospital stay are almost as good as you getting better. The same hand extended with an awkward smile to greet you on the gurney may be the same hand making the sign of the cross while pronouncing your time of death.* I imagine these statements won't actually hold up to statistical analysis thanks to excellent supervision, but it's a medical truth! It is so.

Another medical truth is that there are some physicians that bring with them them the storm clouds of disease close in tow, and then there are some physicians who are bathed in a gentle light of health bringing peace, refuge, and pockets full of medicine wherever they go. Black clouds and white clouds. So far, after two calls, it seems I am a white cloud. Not through any effort on my own part mind you; no one knows how the Gods decide the status of each physician. It is theorized that they either draw lots or simply look down from their collective ivory towers and name off the first few people they see, but whatever the means, once ordained it is unshakable. In my one and a half weeks of residency I have admitted three patients on two call nights and taken care of perhaps another three. This is less than what many teams see in a single call night. Sometimes I lay hands on patients and they get better, blow kisses at children so they'll stop crying, and wink at the elderly so as to resolve their dementia. None of this ever works of course as that's not how the black cloud/white cloud system operates, but I like to do it nevertheless.

And the last medical truth I will share with you all is that most medical truths are contradictory. Some may like to use the term "paradoxical," but, no, they're usually just contradictory. And as we residents are a superstitious lot it is likely that by mentioning my white cloud status just now I have successfully jinxed it. I am on call this Friday. I am expecting sixty patients.

*Actually I don't think most residents make the sign of the cross when pronouncing people dead. Except for maybe the Catholic ones.**

**Is this Catholic racist?

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