Assume the physician
It was on a recent shopping trip with Veronica that it dawned on me
what I had become. Although it initially
seemed to be just another day, much like any other, I was to be proved
wrong. I placed my purchase on the counter and waited patiently while
the young assistant concluded the heated debate about nail varnish that
she was having via the telephone. There was something odd about her.
She caught me staring, and we exchanged perfunctory smiles. Initially I
thought it was simply because she had overplucked one of her eyebrows
(her right) and kept her wild left eyebrow to be tamed for a rainy day
that she caught my eye, but no, there was something else going on. Then
it hit me like a frying pan ... she had a strabismus.
I attempted to catch Veronica's attention, by subtly waving both arms
in the air. Veronica, who was trying on flip-flops, rushed forward. I
mouthed the words "stra-bis-mus" to her and pointed towards the
assistant, who suspiciously looked at us with her functioning eye as we
stared and tried to resist the urge to test her cranial nerves. A few
moments later we managed to drag ourselves back to reality and out of
the shop.
Obviously I was somewhat distraught about the fact that medicine
had permeated into every aspect of my life to such an extent that I
turned buying a pair of trousers into an opportunity to run a clinic.
At times like this, when I feel that medicine has taken me over, I
always phone Patricia, my bellydancing friend who is studying at the
Royal Free in London, for some of her words of wisdom. She consoled me
with the knowledge that she too likes nothing better than to play
"spot the diagnosis" when she is on the tube-the obese woman with
facial hair, the profusely sweating businessman, no one is immune to
her hungry eye. She told me of her astonishment when she noticed a
hairdresser's grossly clubbed fingers and promptly frightened him when
she listed all the things that could be wrong with him. His eyes popped
out, and he snipped too much of her hair when she came to mention
bronchial carcinoma.
Is it inevitable that medicine will take hold of our lives? The thought
does make me feel quite uncomfortable. Some people are quite happy to
have their souls stapled to the profession, only associating with those
that share the language of medicine and excitedly sharing the latest
research in laxative therapy. That makes me feel a little
claustrophobic and frightened, to think that I may turn into one of
those sad fellows who sit in lectures and ask pointless questions just
to show everyone how clever they are.
It was only when my mother phoned me and launched in to yet another
session of bombarding me with a list of ailments she and her friends
were having, and asking for my considered opinion, that everything
slotted in to place. It has always seemed so natural for family and
friends to call me up for a telephone diagnosis or to explain to them
what their doctor meant in their consultation that it does not cross my
mind any longer. I realised then that medicine had not been taking over
my life at all-it was already a part of it. There is a theory that
those who are seduced by medicine have always taken the carer's role
from an early age. They are the ones in the family to whom others turn
in a crisis and when they need help. They are the ones who have a
strong desire ... a longing to be needed for whatever
reasons, be it a deep-seated insecurity, a yearning for some semblance
of power, or an intrinsic altruistic ability to care for others. They
want to be the rocks in other people's lives, regardless of whether or
not they have any security in their own lives. I suppose it was my
fascination with people and their complex behaviour that lead me to
study medicine in the first place, and that fascination has simply been
nurtured through slowly learning the calligraphy of disease and then
searching for those signs in everyone around me, including myself (I am
a self confessed hypochondriac).
And so as the years gestating within the womb of medical school
are fast melting away like snow in the midday sun, and as I continue to
notice the stigmata of illness on the streets of Leicester, I shall not
worry or fret, but simply continue to assume the physician.
Debashis Singh, fourth year medical student, University of Leicester
studentBMJ 2000;08:131-174 May ISSN 0966-6494
