Fireside diagnosis

During medical school, we are awash with a non-stop flow of information. It can be overwhelming at times, and we occasionally wonder whether the material will actually stick over the long term. Our last class, anatomy, finished a couple months ago, but the amount of information we have learnt since makes it seem as if it were years ago.

Sometimes, though, life presents opportunities that reveal just how much medical school is actually training you.

During a recent break, an acquaintance* and I were chatting by a fire pit when he brought up his upcoming surgery. He lifted his left hand and said, “Yeah, I’ve had some trouble with my left hand. It hurts these days, so the doctor is going to do some surgery on it to make it better. I forgot what he said it was.”

Instantly, my mind started analyzing his problem. Left hand pain; my knowledge base whittled it down to muscular or neurologic. “You’re left-handed right? You write with your left hand?” I asked.

He nodded, “Yeah, that’s actually when I first started noticing the pain; whenever I would write it would hurt.”

I started imagining him writing with his left hand. Lefties usually drag their wrist across the page when writing. If he was putting pressure on his wrist while writing, he was probably compressing the nerve that runs through that area. That nerve provides cutaneous sensation to his pinky finger and half of his ring finger while also innervating the hypothenar muscles.

“Did you notice a tingling sensation or numbness on your pinky and ring fingers? And did you have any trouble moving your pinky around?” I asked again.

His eyes widened, “Yeah! Both of those are exactly right!”

My mind fit the puzzle together; tingling, numbness, muscle weakness, manner of onset, and location – ulnar nerve compression injury.

“Did your doctor say you had an ulnar nerve compression or entrapment injury?” I inquire.

“Yeah, exactly! How’d you kno — oh that’s right, you’re in medical school. Well good job! They’re teaching you well.” he replied.

I smiled wide – medical school really is molding us into doctors. Sometimes, we just need the opportunity to see it.

*Details were altered to protect this individual’s privacy.

2 responses to “Fireside diagnosis

  1. It’s always fascinating to witness the gradual transition that occurs as students become physicians. Thanks for sharing this story.

  2. Thank you for sharing such a life-confirming story. It’s nice to know your education is synching up with life.

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