A digital illustration by medical student David Yu.
My foray into the wilds of Alaska was part a journey that my classmates and I call “the Safari.” While no African wildlife are spotted on the trip, bears and moose are plentiful, and the journey traverses over a quarter of the United States landmass, from four-room clinics serving towns of a few hundred people to the massive edifices of a level one trauma center and tertiary care university hospital serving five states. For those unfamiliar with the program, the University of Washington is the only allopathic medical school in the “WWAMI” region, comprising of Washington, Wyoming, Alaska, Montana, and Idaho; the school has clinical sites and regional teaching campuses in each of these states. Come third year, students can request rotations in the multiple hospitals in Seattle, or rotate at the regional sites.
Like poker, medicine has certain rules — patterns of clinical symptoms and lab findings each correlating with a specific spectrum of prognoses that vary in likelihood, the differential diagnosis. Physicians are like seasoned card players, trained to maintain composure and incorporate numerous variables into logical, calculated decisions at what seems like a “dealer’s table” of outcomes. Sometimes, we hedge our bets that the patient will self-resolve, so we elect not to treat; other times, we act conservatively with a battery of tests and pre-emptive therapy.
I tilted the overhead lamp and reached for a fresh blade. My gown was stained from hours of work on the woman’s arm; I continued to scrape, dab and blot. This, however, was not surgery. I was finishing my final project for a college figure painting class.