iatrogenic

The strangest thing you learn in the first year of medical school is that there is a word that exists to describe those diseases that physicians actually give to patients. Iatrogenic. And it's about then that you actually start to think about disease and cure in a tangible sense. It's not so simple anymore.

There's a very cold way we talk about risks and benefits and the balance between them. For example, I think that giving someone IV or IM iron is unacceptably risky for small benefit if the patient can take oral medications. Most would agree. But it's not so clear when you start to think about other things, like giving someone a load of poisons designed to kill cancer cells hopefully before they kill the patient, just to extend someone's life for a few weeks to months, with the knowledge that those weeks will be spent in the hospital suffering from every known infection because the patient has all of 4 white blood cells left.

I went to Applebee's today, the home of mediocre American chain restaurant food, because I was too lazy to try to find a decent steakhouse. I just wanted a steak, and Applebee's is close. While I was sitting at my table of one, I overheard some medical students gabbing away. They couldn't have been 3rd or 4th years. They were talking about the real world. Once you start clinicals, you have to make concerted efforts to talk about things other than the hospital. Anyway, it seems so long ago that I was in their shoes. I didn't understand or grasp the idea that everything in medicine isn't as simple as disease and cure.

I wish medicine was that simple again. I wish that I didn't have to think about what diseases I could cause, rather than what I should be treating. It's not fair to have to fight illness and cure at the same time.