Dec 14, 2009

Picture Books

Being a medical student is a lot like being a toddler. A small child is exposed to so many new things each day, her world grows exponentially in a short amount of time. Likewise, each day I see new things and am exposed to new situations, forming a frame of reference for the rest of my career. We show babies picture books in the hopes that once they see an picture, they will be able to apply that knowledge next time they encounter that image. What else is medical school? I see something once or twice, learning the character of that disease, in the hope that next time I see it, I'll correctly diagnose that patient. Of course, I had a lot of books during my didactic years in school. But the picture books are formed during the clinical years.

Some pictures in my book:
The joy on a father's face when I hold up his baby for the first time
My first written prescription
A tiny 15 week old fetus with perfect fingers and toes, laying in my hands
The subtle differences between polyps, ulcers, cancers, and rashes
The waxy covering on a baby I just delivered
A young patient dying from incorrect treatment of neutropenia
Riding along for a home visit of a bedridden patient
A chest wall covered not with skin but with the surface of an extensive breast tumor, beginning to be gangrenous, and my hand holding her hand
A tiny heart beating on ultrasound

I suppose the nature of these snapshots is that they are something new; something different, shocking, heartbreaking or joyful. You remember them clearly to try to create a healthy experience, to fix something earlier than when you saw it before. There's a weight of these images; a responsibility to know them and learn from them. After all, these picture books form the foundation of a physician.

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