Your Medical Mind_ How to Decide What Is Right for You - Jerome Groopman [18]
When my youngest sister was five years old, she developed abdominal pain and fever. My mother brought her to the pediatrician who was covering the practice of our regular doctor. “It’s nothing, just a virus,” he reassured her.
It seemed that he was right, because the symptoms improved after a day or two. But the next week, my family was awakened late at night by my sister’s shrieks. The abdominal pain was back, but much worse, and now she had a dangerously high fever. My mother plunged her into an ice bath and called the pediatrician. “Get her to the emergency room right now!” he said.
My sister’s appendix had ruptured and bacteria had spread throughout her abdomen—peritonitis. In retrospect, her initial symptoms the week before had been the early signs of appendicitis. I vividly recall visiting my sister in the hospital, hiding in the corner as the nurse entered the room carrying a metal tray containing two syringes topped with gigantic needles. I fled the room in horror before my sister received these painful antibiotic injections into her buttocks and thighs; they were given every two hours. The lesson was clear: Doctors were not always right.
My father was fascinated by science and medicine and wished that he could have become a doctor. When I was young, he encouraged me to be a nurse. As more opportunities opened for women, I decided I would become a doctor. I attended what was then Radcliffe College at Harvard University and immersed myself in science. I had inherited my father’s facility with numbers and was first drawn to the quantitative sciences: advanced mathematics, physics, biophysical chemistry. I enjoyed working with formulas that gave clear and precise answers. But I was also drawn to biology with its inherent variability, where the correct answer could not always be predicted, where normal was not a number but a range, a continuum without clear cutoffs.
My first personal encounter with illness occurred when I was a senior in college. I woke one morning with an intense and painful urge to urinate. When I looked down at the toilet bowl, it was red with blood. Terrified, I ran to the student health service, where an experienced nurse-practitioner reassured me that I was not dying. “It’s nothing serious,” she said, “just a bladder infection, easily treated with antibiotics.” She gave me a prescription for a sulfa drug and told me to call her if I had any problems.
I picked up the medication from a local pharmacy. Enclosed with the medication bottle was a package insert with detailed information about the antibiotic, including a very long list of possible side effects. I read carefully through this information: severe total body rash, liver failure, even death. I was paralyzed. Should I really take this dangerous drug ? Did this nurse-practitioner actually know what she was doing? But my symptoms were too much to bear, so with trepidation I put a pill in my mouth and swallowed it down, fully convinced that I would develop some terrible side effect. I didn’t, and within a day my symptoms were gone. Despite this therapeutic success, I remained, like my mother, a doubter. But being a doubter did not stop me from becoming a doctor.
As a student at Harvard Medical School, I found that my most inspiring teachers were endocrinologists. They seemed to know all of medicine, alert to subtleties in the individual patient’s history and physical exam that could easily be overlooked. Snoring, excessive