Get off my lawn!

Led a small group of first year med students through a couple of clinical cases; first one was sudden onset headache in a young man. We talked about how to generate a differential diagnosis, thinking about what’s urgent and what’s most likely.

One of the students goes, “What about epidural hematoma?”

“Good thought,” I say, writing it on the whiteboard. “What do you think about the fact that the patient’s talking to you and lucid?”

Blank stares.

“OK, so epidural hematomas can have a lucid interval, where the person might look and sound ok until the hematoma hits a threshold size and they decompensate quickly.”

Click-click as they type away (I would rather have said *scribbles* but kids these days with their laptops and snazzy equipment, they wouldn’t know a pen if it hit them in the face.) They seem disengaged; how can I make this relevant for them? Diseases mean very little unless you know, or know of, someone who has it.

“You know, like Natasha Richardson.”

Blanker stares. Finally, one of the students goes, “Who?”

*sigh* “She was skiing and fell, and when the paramedics got there she sent them away, then she went back to her hotel room and died.”

Later on, during a case of parkinsonism, I mention post-encephalitic parkinsonism, Awakenings and Oliver Sacks — no recognition. And when we were talking about dementia with Lewy bodies, I tell them, that’s what Robin Williams had, and they are like “huh?” So I decided not to tell them that Dudley Moore had PSP, because I don’t want to have to explain who Dudley Moore was.

Then after class, I submitted my application for an AARP card, because clearly I’m an old lady now.