Saturday, December 15, 2018

Old doctor pet peeve - disease descriptions were better in Osler's day.

I didn’t know Sir William personally, but I think he’d be appalled by the descriptions of patient-disorders in our medical textbooks.

We typically present a collection of findings, sometimes organized by ‘history’ or ‘physical’ or ‘lab’, but the sequencing and relationships are all lost.

We should have textbooks that describe a disease or disorder with 3-8 case histories that span a reasonable spectrum of presentations. So not x% have red eyes and y% have chest ache, but a case called “common” that might be “8 yo both with cough, then red eyes for day and a swollen lymph node, then a day later some red palms …” and another case called “often”, and 2-3 called “unusual1”, “unusual2”, and so on.

Ok, it’s not just my Oldness. I’ve been grumpy about this for roughly 25 years, even when I was only old in spirit. It annoys me a great deal.

Now I’ve said it.

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