Above all, remember this

Sorry about the blogging hiatus. I have started my internal medicine rotation. It has been really great. I like my attending physician, the resident, the intern, and the other medical student. I even like the nurses. I love working in the wards with the patients. I has been a great experience so far. But, I have been really busy, and working longer hours than any of the other rotations I have completed. So, not much time for blogging.

There are a few books that medical students and residents tote around in their white coat pockets as references. One of them, the one I decided to purchase for this year, is Ferri’s Practical Guide to the Care of the Medical Patient. It does more than make my jacket heavy; it has entries on how to interpret labs, and the presentation, pathology and treatment of common conditions. But, I think the most valuable thing in the book is the quote in the preface:

Pearls of Wisdom in Medicine:

1. Common things occur commonly
2. When you hear hoofbeats, think of horses, not zebras.
3. Place your bets on uncommon manifestations of common conditions, rather than common manifestations of uncommon conditions
4. If what you are doing is working, keep on doing it.
5. If what you are doing is not working, stop doing it.
6. If you don’t know what to do, don’t do anything.
7. Above all, never let a surgeon get your patient.

From Matz R: Principles of Medicine, NY State J Med 77: 99 – 101, 1977.

I think it applies to obstetrics really well, don’t you?

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8 responses to “Above all, remember this

  1. Reading those “pearls” gave me deja vu. I hated my IM rotations – well, that is a strong word, considering I was pretty gung ho about everything back then, but I remember feeling like it was one of the longest rotations and the vast effort on my part yielded little returns – I was not so lucky with rotating staff.

  2. Phledge

    LOL. I fucking hate ward medicine. Here’s hoping you have better luck with it than I do.

  3. So what percent of your cases are c. diff? [I did rounding with inpatient internal med here for a while, it seemed like every other room was c. diff, mrsa, or pneumonia]

  4. Susan Peterson

    In my current job (disability analyst for Social Security Disability claims) I read a lot of bits of charts and notes from medical practices of all sorts. One neurology group from a town called Horseheads, is called, with no originality, Horseheads Neurology. But their masthead clearly shows the heads of two zebras! I long for a chance to ask someone there whether this is a reference to the “if you hear hoofbeats” epigram. In Neurology, I believe, they do have to be alert for zebras.

    I have often wondered; what if what the patient has is a zebra, and his doctors refuse to see anything but horses?

    Susan Peterson

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