This is how awesome I am

Sometimes my preceptor likes to pull me into patients' rooms and say things like, "Take a listen to Ms. Larson's heart and tell me what you think" or "have a look at little Timmy's rash and give me the diagnosis." These sorts of questions usually result in me performing an akwardly long exam in front of everyone and then saying, sheepishly, "is there a murmur?" Luckily, I have gained a local reputation for being *bad at murmurs* so I never know whether she is trying to trick me into saying that I hear a heart murmur that isn't actually there. And when it is there, and I do hear it (which means that the patient's deaf grandma could probably hear it from across the room), I usually can't pick up on the subtleties. Like once I was all proud and said, "Dr. M, it sounds like a holosystolic murmur." And she was like, "Well, its more of a crescendo murmur. Did you hear the diastolic component?" And I was all, "uh, no." And then I listened again and still couldn't hear it.

But enough! I come here to tell a story of triumph!

The other day, she pulled me into a patient's room and told me that she had a congenital condition with some specific exam findings. I was to observe the physical exam and come up with a diagnosis. And I sat back and observed as she began to look in the ears of this very nice patient, who had something a little wrong with their posture and limb positioning. And as she moved to the eye exam, suddenly I saw it: a slight blue discoloration to her sclera (aka the whites of her eyes). "I know!" I gasped. "Osteogenesis imperfecta!" And I was right.

Osteogenesis imperfecta is a disease characterized by brittle bones that break easily and frequently, often leading to physical deformities and deafness. Kind of like Samuel L. Jackson's character in the movie Unbreakable. The hallmark of the condition, the thing that you learn in medical school, is that the whites of their eyes are blue. It was kind of exciting to actually see this disease.

It was a disease that once formed a very minor and very stupid sideplot on the only episode that I ever saw of a very awful circa-2004 medical drama called Medical Investigations. Also known in some circles as Poop Investigations. This inane sideplot involved a young novice investigator stealing the national stealth investigator helicopter and traveling thousands of miles to a hospital where the parents of a young girl were about to be acused of child abuse because the their daughter had multiple fractures... and turned out to have osteogenesis imperfecta. But apparently all of the multiple doctors taking care of this girl had never heard of the disease and it took a hot shot rebel medical investigator to solve the great mystery by saying: "take a look at her eyes - are they blue?" Why do I fixate so much on this show? Anyway, I am proof that a lowly medical student in a small family practice clinic in Astoria, OR can solve the same mystery within 30 seconds without calling in the national guard.

That is how awesome I am. I am also awesome because today I was able to correctly identify the first case of molluscum contagiosum that i have ever seen in another one of Dr. M's "come in here and look at little Suzy's rash" teaching moments. Awesome!