Triage

One of the (many) perils of going to medical school is the whole concept of phone triage. That is, when someone calls you up and wants to know your medical advice for their current ailment.

The first time it happens it's almost universally so early into medical school that you have no idea what to actually say to the person. But you feel awesome that someone thought to call you. Medical school is interesting in that most people have little or no patient contact until the third year. So when you're a first year student, you can think of that one weird disease you just learned about in histo or micro, but really you don't even know what to ask next. Then you get to second year. Second year's classes are all about things that go wrong in the body. The "zebras". So when you get that call all you can think of is that rare African tribal disease that it "just might be." It never is. And of course along with second year comes the supressed hypocondria. Everytime you yourself have any symptom at all you think you have lupus or colon cancer or leishmaniasis. Never mind it's pretty unlikely. You probably have it.

Then you hit third year. Actual daily patient contact and real medicine. You start to learn the differential and actual effective history taking. That's also when "I don't know" becomes the only thing you can think of during that phone call. "Ummmm. I don't have Peds till next semester. Better call someone else." Then you finally get to fourth year. Blessed fourth year. You get to where you think you know everything. You've passed your step 1, 2, and 2CS. You've gotten boat loads of invitations to interview at residency programs. You've turned down interviews. And then you get that phone call. And all you can think is the absolute worst case scenario. "She says her neck hurts and she has a fever." "Oh my gosh - it's meningitis". "She says her stomach hurts when she eats fatty foods and now she's vomitting." "Oh man - I hope it's not cholangitis." And so your answer becomes the same for every single phone call. "Better take 'em to the ER. Just in case."

So if I've told you this year to go the ER and it turned out to be nothing, or if you called and all I could say was "Ummmm. I don't know", or if I told you that you have a rare African tribal disease that comes from eating human brains, I'm sorry. It's just the way of the med student.