I hear people say that the fun is gone from medicine. Certainly, the bureaucracy is increasingly burdensome. However, the practice of medicine still has a lot of opportunities for fun. One of the great pleasures of medicine is solving the intellectual puzzle of the challenging diagnosis.
Diagnostic technology has come a long way, and it is possible to make a diagnosis using brute force. However, we all remember our admiration for the great professors in medical school who were able to come up with a critical diagnosis by noticing some subtle physical finding or asking just the right question of the patient (the one that you forgot in your 1-hour detailed history). Those kinds of superstar diagnoses are embellished by memory and retelling and clearly are not a realistic goal for everyday practice. I do think that a realistic goal is to be able to make what I call an “elegant diagnosis.”