Recently I’ve become aware of the dark side of being a medical student. My husband calls it “The Burden of Knowledge”. It goes something like this: in a conversation, a person is complaining of a random ache or pain. Your brain, while also trying to be as sympathetic as possible, automatically goes to a long list of differential diagnoses and before you can catch yourself, you start asking questions to narrow it down. Ultimately, because the worst pathologies are the most memorable, you decide on the worst outcome possible.
At this point in my education, this becomes obnoxious in a couple ways. First, your friend didn’t even ASK you to start diagnosing. They were just making conversation and you HAD to take it to that level. Seriously, my brain is like a dog chasing a car. It just can’t stop itself. Second, even if I DID manage to elicit a diagnosis: first, I can’t tell you what I think and second, I couldn’t do anything about it if I could! You feel a momentary glimmer of pride and doctor-ness, only to have it come crashing down when you realize that yes, you figured this out, but NOW what are you going to do?

Well Crap.
Another thing that totally kills your self-esteem is when family comes to you asking for your “medical opinion”. Right now guys, my “Medical opinion” definitely belongs with quotes around it- and those sarcastic quotation marks too. Also, even with family, that “medical opinion” comes with the legal disclaimer that makes your family’s eyes glaze over or roll back in their heads. Please don’t sue guys!

Please don’t sue guys!
The last, and most sobering, aspect of the burden of knowledge is when you are right (sounds like a good thing, but you are SO wrong, my friend). Recently, I found out my grandma was in the hospital. She had some preexisting health issues that I was aware of but, that wasn’t the problem. My brain, faster than I even realized, immediately scrolled through an apparently premade list of differentials. And I selected the worst one (call me a fatalist).
The next day, I got an update on my grandma. I was right. That was the WORST feeling in the world. I know it’s impossible, but I honestly felt like it was my fault. I felt I caused the progression of her disease and now her time was limited. By just verbalizing my thought process, I made the worst happen. I was the biggest jerk in the world.
This is what people don’t warn you about. They don’t warn you that you are now equipped to accidentally diagnose someone correctly, when that diagnosis is the LAST thing you want for the person. They don’t warn you of that heavy feeling you can’t shake when you know something is seriously wrong with a family member and can’t say anything.
And they don’t warn you that it will feel like it is your fault.

Palate Cleanser