White Coat Underground

Thanks, Doc

I was one of those crazy folks who loved medical school—not just the clinical years, but the pre-clinical sciences as well. The transition from pre-clinical to clinical can be rather unnerving (picture learning how to do a pelvic exam on paid models). One of my first clinical experiences was in our physical exam class. Much of this was done on each other (not the pelvics), but we were also paired with attending physicians who would take us to see—gasp!—actual patients.

The guy I was paired with was old—impossibly old. I wondered to myself if he still had a jar of leeches in his office. But he wore medicine like an old, comfortable coat. I, on the other had, was wearing my short white coat for the first time, and feeling particularly clueless. When we were on our way to see some of his hospitalized patients, he said we had to stop by the ER to see a patient of his—the ER! Cool!

The one thing I remember was the EKG. He picked it up, glanced at the red and white paper with the 12 separate tracing on it, and said, “yeah, he’s probably fine.” He didn’t teach me to read EKGs. But he showed me that some day I would be able to glance at one for a moment and pronounce someone “OK” or “not OK”. It was magic.

Anyway, my alumni newsletter arrived in my inbox today. “Dr. Paul Winter was a senior attending physician and associate professor of medicine emeritus…He is survived by…”

Thanks, Dr. Winter, for helping keep the magic alive.

Comments

  1. #1 Ranson
    August 20, 2009

    I gained a greater respect for my PCP a while back when we took our son in for a visit. A med student was observing, and when my doc looked at the situation, it was all he could do to not burst out with a stream of cusswords.

    My son had a gash on the top of his head that the emergency room had stapled shut (without even shaving the spot, because he had such “beautiful hair”). Well, he was healed up, and it was time to follow up. My doc turned to the student and said (quietly):

    “This is stupid. They should have sutured him, so that we, weeks down the road, could snip a couple of threads, tug them out, and send him on his way. However, to save five minutes of their time, we now have to take pliers to the head of a toddler, and pry out a handful of staples. This will hurt some and frighten him more. Just because a treatment works and is easier at the time doesn’t mean there isn’t a better way.”

    I love my doctor. That student was sufficiently freaked by the process that I doubt he’ll ever use a surgical staple. Well, he’ll at least consider if it’s the best way.

  2. #2 D. C. Sessions
    August 20, 2009

    There’s really only one way to repay those who gave us such precious gifts. And somehow it’s never enough, is it?

  3. #3 antipodean
    August 20, 2009

    You’ll have to explain the coat length thing to us non Americans at some point.

    Nobody wears white coats here anymore except a few odd examples who tend to be the oldest physicians.

    Maybe it’s like the esoterica of academic gowns we’ve inherited from Oxbridge?

  4. #4 PalMD
    August 20, 2009

    It’s very institution-dependent. I’m actually rather bad about wearing mine. In general, short white coat=medical student, long white coat=attending physician.

    Where I did my residency, it was long baby-blue coat for resident, long grey coat for attending.

    At some places, interns wear short white coats as well.

    At mayo, they wear suits.

  5. #5 JustaTech
    August 20, 2009

    And how to tell a scientist from a doctor: only the doctor will ever been seen in public (ie out of the lab) in a lab coat. In the lab, a lab coat is for collecting cooties (bacteria, viruses, bleach, assorted materials) and keeping them off the clothes you wear to lunch.

  6. #6 David
    August 20, 2009

    My introduction to the neurologic exam was by the late Wigbert Wiederholt, then in his 50s. You may know him for his book “neurology for non-neurologists.” His clinical skill was what inspired me to pick my specialty. I taught medical students and residents for a dozen years and always remembered his teaching style.

    “To consider dear to me, as my parents, him who taught me this art”

  7. #7 Harry P.
    August 30, 2009

    I’m stuggling to service my second year of med school. I (should) have Dubin’s “Rapid Interpretation o EKG’s” in front of me trying to understand hemiblocks. It’s nice to know that maybe (if i pass) I’ll be able to look at an EKG and know what’s going on quickly.

    Heck, I may even forgive my prof for putting us all through this.

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