Wednesday, November 11, 2009


One problem often faced in medical education is that, when seeing a particularly rare, serious, or classic presentation of a disease, the first impulse for students and residents is usually to say, “Oh, cool!” …after which, the immediate second impulse is to feel like an insensitive jerk.

I’m guilty of this myself. Of course I don’t think it’s cool that the patient who was admitted with anemia is discharged with a diagnosis of soon-to-be renal failure. But following the course, and observing the lines of reasoning, and then watching the pathologist point out the problem on the biopsy? That’s pretty exciting, from a learner’s perspective. (The resident, looking at the slide, exclaimed, “Wow, that’s so cool! --Well, I mean, it’s not cool for the patient…”)

On my Ob-Gyn rotation last year, a fellow student and I were discussing this problem. We were both killing time in the pre-op area, and I was animatedly describing the surgery I had just seen, in which the middle-aged woman who went in for a hysterectomy (she had endometriosis or something, I think) was discovered, on the operating table, to have what looked like cancer.

And all of a sudden we looked at each other and realized how much that sucked, and how weird and kind of disturbing it was that we were smiling and chattering about it like football fans reliving a particularly thrilling touchdown. So right then and there we coined a new word for such situations: learnful.

Not that I actually say “learnful” in most situations… because really, almost no one would know what I meant, they’d give me weird looks, and I’d be no better off. But still, it’s a good way to think about it. The best way to learn about disease is by seeing it, and yes, learning is cool. But we’re still talking about real people here, and real lives being ruined. And that is definitely not cool.

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