Now that we’ve started pathology, I find my medical brain conflicting with my human one. We learn about a new disease, or learn a new term, and my medical side gets all excited. “Sudden death from coronary artery occlusion! What my mom’s friend’s husband probably died from!” But then the human side kicks in: “What kind of sick person are you? Excited about disease? About his death ? What’s wrong with you?” And so it goes. ALS (Amyotrophic Lateral Sclerosis) was mentioned last quarter. “Oh, my grandmother had that!” Thromboembolism ! I wonder if that’s what happened to my Nana the other day .

It’s the fact that I realize my sadistic excitement that keeps me from really being bothered by it. I recognize that I’m excited to be able to apply and relate my classroom memorization to actual people. And while I say all this, I still feel that there’s something I’m beginning to lose–or lose touch with–in my stress-filled flurry to cram all this knowledge in my head. The excitement itself devalues the person. I feel as if I should, at least, feel something other than excitement. Maybe anger. But anger doesn’t fit, either. I’m out to stop disease, or better, fix it. But not in some sort of angry, vengeful attack. I’m out to stop it as a clinician. Through logic. Science. Education. Medicine .

This is, of course, just another phase, which will, in time, fade. But it just concerns me that I’m glossing over the humanity of the illness just so I can learn it. Especially in such a stereotyped, categorical fashion. Hopefully I’m the last generation that learns it this way. With the advent of technology, I’d love to see less emphasis on memorization of facts of rare diseases, and more emphasis on communication and listening skills. Doctors will always need to know what the symptoms of a heart attack are, but why memorize a rare disease when you’ll have a PDA (or at least a book) to look it up? I don’t want to think of patients as mneumonics. When I think of gallstones, I don’t want to think, “female, fat, forty, fair .” We categorize in medicine to make sense of our world, to label it, and ultimately, to treat it. But if we only emphasize categorizing, we end up with patients that don’t fit in our neat little checkboxes, and we ignore the patient’s wholeness. We make them their disease. It’s a little too much like Freud’s theory of fetishism , in my opinion.

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