Medical Dog Years

The number 7 is very interesting. We have 7 days in the week because the ancient Babylonians studied the celestial sky, and noticed that all the objects of firmament were fixed in relation to each other, with the exception of 7 — the sun, the moon, and the five planets that are visible to the naked eye. They worshipped them, and named a day for each, bringing order to time.

Likewise, human endeavor has brought order to our medical knowledge, our scientific and clinical data base, which likewise turns over every 7 years. (A practicing physician can expect a medical malpractice suit, on average, every 7 years. Are these facts connected?)

With such a rapid turn-over rate of knowledge, a physician, academically speaking, ages like a dog.

I entered medical school in 1973. This was before some of my colleagues were even born. How old am I, academically speaking, in dog years?

My medical world has changed so much that I now experience what my older colleagues must have felt when I first rubbed shoulders with them. I was fresh from training and so sure of myself and my knowledge base. Many of them had trained after World War II, when antibiotics were only becoming available. Can you even imagine what the practice of medicine must have been like then? Now I can.

How old am I? I’m so old, in medical dog years, I should be (academically) dead.

I'm so old, that my colleagues once cited references from medical text books.

I'm so old, that "googling" meant staring at a women's décolletage.

I'm so old, that "baby aspirin" was given to children, not adults.

I'm so old, Penicillin was regularly prescribed.

I'm so old, that we used Clindamyacin all the time and no one ever heard of C. Difficile.

I'm so old, that a new drug was soon to be released, called Captopril, for heart failure.

I'm so old, that the treatment of COPD was revolutionized when the first calcium blocker, Verapamil, became available and we could avoid the "risk" of beta blockers.

I'm so old, that my first year tuition at Boston University Medical School was $2,800.

I'm so old, that part of an abdominal work-up included a barium enema, after you did a rigid sigmoidoscopy to be sure the rectal vault was "safe" for the inserted balloon.

I'm so old, I did rigid sigmoidoscopy. In my office. On a funky, folding, tilt table that had patients mooning the ceiling.

I'm so old, that Lyme disease only referred to someone who kept shopping at outlet malls in a small Connecticut town.

I'm so old, when I trained, AIDS didn't exist.

I'm so old, that Nurse Practitioners only did pediatrics, and a "Physician Assistant" booked appointments and brought you coffee.

I'm so old, that nurses stood and gave up their seats when a doctor entered a work station.

I'm so old, that oral Vancomycin didn't exist.

I'm so old, that anticholinergic updrafts were controversial.

I'm so old, that you never gave nitrates in the setting of heart attacks, for fear of a vascular "steal syndrome" worsening ischemia.

I'm so old, that a doctor's desk top had ashtrays and not computer screens.

I'm so old, that you "punched in" to the switch board when you entered a hospital, so the operator knew you could be paged overhead.

I'm so old, that CT scanners were so expensive they would be shared by hospitals, mounted in trucks, and only available when parked outside the building.

I'm so old, everybody got a Swan Ganz catheter in the ICU.

I'm so old, dictations were short and patient visits were long.

I'm so old, I carried my first mobile phone in a shoulder bag.

I'm so old, computer print outs always had strips of perforated paper running down both sides.

I'm so old, every hospital had exclusive doctor dining rooms and parking areas.

I'm so old, there was no such thing as health care providers or health care consumers. You were either a doctor, a nurse, or a patient.

I'm so old, my colleagues no longer argue with me. They roll their eyes and walk away.

I'm so old, I can say outrageous things at staff meetings and no one tells me to be quiet.

I'm so old, I can admit I don't know something and not feel embarrassed.

I'm so old, No one expects me to volunteer for anything.

I'm so old, I fart dust.

-alan berkenwald, md