Frying Pan

Yesterday, I sat back and watched as six of my classmates got boiled and fried and grilled during their CPC (Clinicopathologic Case) presentation.

To be fair, they had a very complicated cardiology case which involved a hypertensive, diabetic, dyslipidemic man with an acute chest pain. They diagnosed him as an NSTE Myocardial Infarction.

To diagnose an MI, you need two out three. That was what the consultant (who had given our cardiology module lectures) had drilled inside our heads. Acute chest pain. ECG. Cardiac enzymes. So the patient had acute chest pain but the ECG result was pretty ambiguous. Their mistake was in considering the CKMB elevated when in fact, it did not meet the criteria.

I squirmed in my seat as they tried to defend their diagnosis, and failed to answer most of the questions, knowing full well that in all probability, I could very easily have made the same mistakes.

What the group missed out was that one tiny detail in the echocardiography result and chest CT which would have explained all of the patient's symptoms. They missed the findings of an intimal flap which could have clinched their diagnosis. It was an aortic dissection.

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It will be my group's turn in the frying pan soon enough.

The consultant in charge of our case was out of the country so our case presentation was postponed. I still have no idea when it is going to be. I have a feeling we will be dealing with a *insert drumrolls* neurology case. [

We. Are. So. Doomed.

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These case presentations give us a chance to apply what we've learned in medical school these past three years. We are given real cases and are thoroughly evaluated on how we come up with our diagnosis.

If we get the diagnosis wrong, it will be a couple of minus points for us. But the thing is, pretty soon, we'll be out in the real world, where clinching the diagnosis is a matter of life or death. Treating an aortic dissection patient with an MI regimen is simply catastrophic.

This is such a heavy burden to bear. But that's what we're training for. Because that's what we were born to do.

And now, enough procrastinating.

=)