Last in his class in Medical School

I’ve known a handful of students who have gone on to medical school and now are practicing physicians.  All of them were in my opinion very intelligent.  Most of them were excellent scholars.

There’s a legendary Q&A anecdote about physicians.  It goes like this:

Q:  In Medical school, what is the name they give to the guy that graduates last in his class?
A:  Doctor.

Not all Doctors are created equal.  In every profession, whether you are a machinist, an economics professor, or a medical doctor, there is a large range of knowledge, skill, and ability among the practitioners.  We’ve all heard stories about the importance of seeking a “second opinion” when making personal health care decisions.  Now let me tell you our story.

About three weeks ago my wife fell and broke her upper arm.  We went to our local hospital where the break was x-rayed.  The humerus bone broke just as it enters the “ball” in the shoulder.  The family doctor told us that you cannot put a cast on this type of a break; Deb would just have to put her arm in a sling and eventually it would heal.  Ten days later the local orthopedist looked at the arm and said that it was in the process of healing.  My wife was experiencing a lot of pain as the humerus bone constantly rubbed against the ball joint.

A week after our local orthopedist took a look, Deb went to the Mayo Clinic for an oncology appointment.  The oncologist suggested that Mayo x-ray the break and run it by their orthopedic department.  “Why not?”, I thought.

The next day we got a call from a renowned orthopedic physician at Mayo.  He wanted to look at the arm.  When we arrived he told us that the ball had shifted out of position during the fall.  If the arm healed on its own, Deb would never be able to lift her arm above her waist, not to mention another 6 more weeks of continuing pain.  “But I thought you couldn’t cast these breaks”, I said.  “We’re not going to do that, he said.  There is another option.“

The Mayo doctor scheduled Deb in for surgery the same afternoon.  One end of a donor bone was set into the top of the humerus and the other end was glued and screwed into the ball.  Three hours later her arm could be lifted in any position without joint pain.  In essence, he had repaired the break; the break no longer existed.  Now Deb must endure only the pain from the suture as the wound heals, but this is minor pain compared to her earlier discomfort.

I’m not going to badmouth my home town clinic or the local orthopedic doctor.  I’m sure that every clinic in the country has at least a few “world class” physicians on staff.  However, on average the most brilliant and highest skilled doctors successfully compete to serve in the largest and most prestigious institutions.  If you are facing a major health care decision (1) always get a second opinion and (2) make sure it comes from a physician in another institution.

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