Wet Bar of Soap

by Lorien E. Menhennett

wet bar of soapIn medical school, life is not like a box of chocolates. It is like a bar of wet soap. Just when you think you’ve figured out how to reliably tell AVRT from AVNRT on an EKG … pffffft. The slippery bar flies from your hands, hits the floor, and skids across the tile, as far out of reach as possible.

There are moments like that. LOTS of them. They are insanely frustrating.

But there are also moments like this: You read a case example about a middle-age male patient who has 9/10 chest pain. Your “job” is to rule out myocardial infarction. Among other things, you pick up on the fact that his sharp pain is worse when he breathes or lies down — but sitting up and leaning forward helps. You pick up on the fact that he recently had a viral illness. Your first thought is “pericarditis.” And you were right.

Of course, this wasn’t a real person. It was a textbook case, and nothing was at stake. But still … you had the right idea. You were asking good questions and putting the pieces together to rule some diagnoses in and others out, or to change your level of suspicion.

You’re still going to drop that bar of soap. You’re going to drop it time and time again, even after you’ve graduated from medical school and become a real doctor. But those other moments — the moments when you get something right, even something really small? Those moments reveal progress. And that means you’re headed in the correct direction.