Interesting Cases

Back when I was in veterinary school, Dr. Larry P. Thornburg was a lecturing pathology professor (as opposed to the hands-on pathologists who worked with us in the laboratories).  One of my favorite Thornburg-isms was "This is a very interesting disease — we don’t know a thing about it."

When we moved on to the clinical aspect of our training, one would occasionally hear the clinician (the instructor/doctor in charge of the case, as opposed to the lowly student in charge of all the work on the case) say, "This is a very interesting case."   It didn’t take too many of those pronouncements to realize that interesting cases were living on borrowed time. 

The thing is, if you’re an expert, and you know all about the regular stuff, seeing the routine, run of the mill disease or injury is just "ho-hum, seen it all before".  For things to get interesting, it has to be something really unusual, something that is hard to figure out, something that maybe nobody has ever seen before.  In other words, it may take a while to figure out what’s going on (maybe such a long while that you’re too late to help), and you may have to invent a new treatment, or there may not BE a treatment.  In a teaching institution, that translates to a very interesting case report, complete with post-mortem results and microscopic analysis of the deceased’s diseased organs.

I’m telling you, you don’t want to be an interesting case.  When the doctor starts calling in everybody to look at you because your disease is so cool and unusual, it’s not a good thing.  You want to be Mister Dull, Mister Boring, Mister See-these-everyday.  It’s like the old Chinese curse: "May you live in interesting times." [Read your history books — "…and there was peace and prosperity for 100 years." versus plague, pestilence, war, famine and other interesting things.]

Don’t get me wrong, now — I love an interesting case as much as the next guy… just not at five o’clock (or six o’clock, or any o’clock when I’ve had a long, full day and would like to go home, for heaven’s sake).  Of course, I love it a lot more when I figure it out in time and the patient gets well. I’m batting .500 this week.  Monday we had a really interesting case that has gone on to that great litterbox in the sky.  Tuesday we had a really interesting case that is a whole lot better today. Both days had me working till eight o’clock, and back here again until ten.  It’s never dull around here, but today was a little less interesting.  I’m okay with that for a while.

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