I’m not one who easily admits when she is wrong.  But on the very rare occasion when it does happen, I try to learn from the experience and share my wisdom with others.  During my current rotation I’ve been thinking back to my Pre-Med days.  I remember being asked over and over again why I was an English major if I wanted to become a doctor.  I never had a great answer.  I usually just said, “Well, I really enjoy reading and writing.”  However, I do recall on multiple occasions telling people that doctors don’t really use science on a day-to-day basis, but they do read and write.

I know that sounds bad, but I honestly believed that after medical school, doctors didn’t really retain all that science.  Doctors just take histories, perform physicals, and then write prescriptions.  That’s it.  Right?

Wrong.  So wrong.

You get pimped a lot as a third year medical student.  It is part of the tradition of medical training.  And it sucks.  My preceptor always asks me to explain the pathophysiology.  If you don’t know what “pathophysiology” means, it basically means science.  Explain the science behind the disease process in our patient.

Even if I know the right diagnosis.  Even if I know the right treatment.  He still asks me to explaint he pathophysiology.  And it’s so freaking hard.  I really, really have to think about it.  I search the darkest recesses of my mind to find some kind of explanation.  I remember learning about this sometime during first year.  Something about cells.  Maybe cytokines.  Something destroys something….then releases something…Arrrrgggghhh!

Learning the pathophysiology is really hard for me.  Biochemistry and physiology were my worst subjects during first and second year.  And part of me hoped I could just forget them.  But the truth it, I can’t.  When my preceptor pushes me to think, at some point, maybe with a little prodding, I figure it out.  And then it’s like a light bulb goes on in my head.  Everything…makes…sense.

Once I can explain the pathophysiology, I can understand why the patient is complaining of certain symptoms.  Then I can explain what tests we need to order.  Then I can understand why the prescription we write is going to work.  And so much more.  Now I can think of other things to worry about.  I can think of alternative therapies in case the current one fails.  If I understand the biochemistry of the drug we prescribe, I can anticipate the side effects.  And it all starts with the science.

The best physicians I have gotten to work with know their science.  That’s why they’re the best.  Just because they look like they’re not using science to do what they do, it doesn’t mean the wheels aren’t in motion behind the scenes.

I think one of the beauties of medicine is all the science that goes on in your doctor’s head – without you even realizing it.  I think it’s one thing that sets physicians apart from other providers.  It’s why medical school is as long as it is.  And there is no replacement for it.