Recently, our MS-2 class finished winter quarter and moved one precarious step closer to the wonders of clinical Candyland and all its third-year clerkship glory. To celebrate this historic accomplishment, several of our noble band – including Dan, Old John, Stalker-y John, Robby, and Beth (Mrs. Robby) – traveled to Montana for a manly wilderness adventure. (Kevin wasn’t allowed because the state of Montana has an Asian quota that was met when I joined the trip).
This sort of trip means several things: (1) an ungodly amount of pork consumption (Beth managed to create this); (2) an uncomfortable amount of “That’s what she said" jokes; (3) a nonstop country music bonanza; and (4) 5 med students and an RN (who knows approximately 4.3x more than the rest of us combined) having nerdy faux-medical debates for 4 days.
After a productive morning of snowy adventuring (them) and sleeping (me), we cranked up the country and were treated with a stirring performance of Rascal Flatt’s “Skin,” which tells the story of Sara Beth and her fight against an unknown hematologic malignancy.
We did what any reasonable Spring Breakers would and beat the song to death with the following lively discussion:
After listening to the song, one thing’s for sure: someone’s a poor historian. Seriously Sara Beth, how can we help you without more details? Associated symptoms? Fatigue or fever? Throw us a bone. And Rascal Flatts, did you even go to med school? This OCP is just awful. Even the referring physician’s dropping the ball (“Between the red and the white cells, something’s not right?” At least give us a blood smear.). Clearly we have to do all the work…
First, Sara Beth’s only a teenager, so we’re immediately thinking ALL.
Easy bruising? Sounds like thrombocytopenia.
Mixed “red and…white cell” involvement? Could be an expected pancytopenia.
An aggressive chemotherapeutic regimen with a ~70% cure rate (lowered to "six chances in ten" for Sara Beth due to her older age and its negative prognostic contribution)? Perhaps a little CVAD induction therapy.
If needed, we’ll be ready for marrow transplant on second remission after relapse.
Go enjoy your prom, Sara Beth. We’ve got it from here. Now, if you’ll excuse us, the kid from "John Q" needs a cardio consult for his hypertrophic cardiomyopathy and then we’ve got a 3 o’clock to get a CD4 count from Andrew Beckett in "Philadelphia."
Your son's next, Denzel...