There are a number of aphorisms that one imbibes over many years of medical education, especially in medical school. Some are useful; some are not; but some stick with you for reasons that even you can’t figure out. For example, I still remember my first day of medical school over 30 (!) years ago. It started with an introductory session beginning at 8 AM that lasted about an hour, an “orientation,” if you will, after which classes began as normal. During this orientation, members of the medical school leadership, such as deans and the chairs of certain major departments, got a chance to speak to the brand new medical students, introduce themselves, and impart a little wisdom, such as they saw it. Not surprisingly, there was the usual “rah rah” about how lucky we were to be attending the University of Michigan Medical School, how we were the elite, the 170 or so students accepted out of over 3,000 applicants, the usual blather. I imagine that it’s the same sort of thing they do now in “white coat ceremonies,” but back then there was no real ceremony, and, as far as I’m concerned, it was good that there wasn’t. I personally find white coat ceremonies that nearly every medical school now indulges in when a new class enters the school to be just a little too reminiscent of rituals welcoming new initiates into a religion for my liking.
Be that as it may, one thing I remember from the thankfully nonexistent pomp and circumstance I experienced starting medical school. The first was one of the professors (I forget which one) telling us that, ten years after we graduated, we will have forgotten at least 75% of what we learned, but what we remembered would be the “right” 25% for our patients. He also told us that at 50% of what we learned would be out of date; so we would have to learn to learn.
Another aphorism that I distinctly remember from later in my medical school experience was delivered on the very first day of my pharmacology class. Within the first five minutes the professor told us that all medications were poisons. They all interfere with normal cellular processes in some way. The ones we use as physicians just interfere with cellular processes in a way that can be beneficial in disease, and, quoting Paracelsus, he noted that the dose makes the poison.
Another aphorism that I distinctly remember from later in my medical school experience was delivered on the very first day of my pharmacology class. Within the first five minutes the professor told us that all medications were poisons. They all interfere with normal cellular processes in some way. The ones we use as physicians just interfere with cellular processes in a way that can be beneficial in disease, and, quoting Paracelsus, he noted that the dose makes the poison.
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