Monday, July 6, 2015

A 21st-century medical student's vade mecum

In the Middle Ages, physicians didn't have smart phones or tablets to help them remember important but random bits of information. Instead, they used a small book called a vade mecum (literally, "go with me"). When I "re-entered" medical school last summer, I didn't have a smart phone either, and I wanted a way to collect the hundreds of facts I would be acquiring as I entered the wards and clinics. So I decided to buy myself a little book. The idea was that I would keep it in my white coat pocket for easy reference. However, all the small booklets in the store were drab and ugly. I didn't want to hate looking at my little book for the next 2-3 years. So I bought a slightly larger one with a snazzy cover and four colors of pages. It doesn't fit in my pocket due to the metal spine, so it has lived either in my bookbag or on my desk. Some clerkships have lent themselves to using it more than others (internal medicine and family medicine, yes; Ob/Gyn and surgery, not so much). Now that I am studying for my next round of board exams, I keep it next to me, more to write things down in order to commit them to memory than to jog my memory when answering questions.

Blue is for pathology. On the left in purple are leukemias. On the right in red is Multiple Myeloma: "Bone pain + anemia = MM until proven otherwise."

Red is for clinical pearls and best-practice guidelines.These heart murmurs are differentiated by color, too: green for systolic murmurs and purple for diastolic murmurs.

Grey is for "Miscellaneous," including dermatology, pediatrics, and anatomy. Here I have drawn the musculature of the eye and the major tracts of the spinal cord. "Head trauma can stretch cranial nerve IV, but increased intracranial pressure is more likely to affect cranial nerve VI."

Green is for pharmacology. (I was thinking of Mr. Yuck!) From this catalog of Drugs and Their Antidotes: "Arsenic poisoning smells like garlic and presents with seizures and nausea, vomiting, diarrhea."

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