Last week, while I sat studying pathology at a neighborhood cafe, a
woman walked up and waved her index finger in front of me. "You're a med student,
right?" I nodded. "I cut my finger with a razor," she said. I examined the
cut on her finger as if it were a rare curiosity. The cut was as erythematous
as most mild lacerations. I could not readily identify any foreign bodies.
I asked, astutely, if it hurt. She nodded. I said, "Looks OK." She thanked
me and left. For five minutes, I felt aglow in godliness. Then, I panicked.
Who was I, unable to distinguish a Mallory body from a keratin pearl, to know
when a finger looks OK? A differential erupted in my mind, ranging from potentially
lethal infections (tetanus? hep C?) to other oft-overlooked diagnoses like
von Willebrand deficiency (who knew how much she bled?) or amyloidosis.
Rosenbaum L. Ethical Issues in Medical Education. JAMA. 2004;291(1):118. doi:10.1001/jama.291.1.118-b
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