Friday, January 09, 2009

He exceeds even himself



No, the title is not some immodest boasting about my academic performance. Instead this is another episode in the continuing saga of foolish classmates in medical school. Faithful readers will no doubt recall a certain individual who, when questioned about diarrhea caused by food poisoning, confidently asserted the diarrhea was indubitably due to duodenal atresia (a congenitally non-patent gut tube). This same individual surpassed that poor showing yesterday.

The picture above is of a Littmann Cardiology III stethoscope. What you can see is one side of the stethoscope that is configured to be a pediatric diaphragm. The opposite side looks exactly the same, only larger as it is an adult diaphragm. Just for absolute clarity, this stethoscope, configured as shown, has two diaphragms.

In our physical diagnosis class, we have been learning to do an abdominal exam. Part of the exam requires that the medical student auscultate the abdomen to hear bowel sounds. In order to do so, we are to use the diaphragm of the stethoscope. The protagonist of our tale (not me, but duodenal atresia boy), took his turn to auscultate the standardized patient. With his Littmann Cardio III, configured exactly as the image above shows, he sheepishly asked to borrow one of the other medical student's stethoscopes since his lacked a diaphragm. This confounded everyone in the room, including the standardized patient who asked him "how does your stethoscope not have a diaphragm?", to which he replied "this is a pediatric stethoscope, it doesn't have a diaphragm."

Now, to be fair, this could be an honest mistake for a medical student to make. The only problem is, we're not first years anymore who only have stethoscopes we've received as gifts and no formal instruction in their use. Dr. M has lectured twice on medical equipment, there have been presentations by 3M, makers of littmann products, as well as by Welch Allyn and other equipment manufacturers. Scariest of all though, is that we've been instructed and tested on the cardiac exam, which requires knowledge of where and what sides of a stethoscope to use, as well as the respiratory exam which requires the use of the diaphragm on a stethoscope. So, barring attendance-optional corporate presentations, there have been 3 physical exam lectures, 3 reviews, and 2 equipment lectures that should have clued our protagonist in regarding the parts of his stethosope. Even more shocking, is that, regardless of how he would have put the stethoscope on the patient, assuming of course that he wasn't using the earpieces or the tubing, he would have put a diaphragm on their abdomen, yet he didn't have the sense to realize this. Wow. Strong work lad.

4 comments:

Mindy said...

Duodenal atresia boy is a prime example of how not all doctors are created equal. Just because they have the title doesn't mean that they're good. It sure makes me want to ask my doctor what kind of a student he was in medical school. I also makes me wonder how duodenal atresia boy is going to make it through medical school in the first place.

Natalie said...

so... what you're saying is that this guy is going to be someone's doctor one day. that's not a good thing.

Dan's Mom said...

Sounds like Charlotte's dad might have been playing the "standardized patient". And yes, someone will graduate last in the class.

Katie said...

Wow. That's really horrible.

I'm pretty sure that I learned this much about a stethoscope from TV when I was 8.


I would have loved to see Dan's reaction to that!