Preclinical
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You Don’t Until You Know


The library opens at 8 a.m. As usual, I overestimated my commute and arrived almost 15 minutes early. This became an everyday occurrence for not just me but for another library inhabitant like myself, That one guy. As I approached the library’s closed double-doors, I saw that one guy waiting. He had an old book in his hands as he always does. By the look of the weathered cover, I couldn’t tell if this book was subject to over-use or just abuse. That one guy has been inhabiting this library for at least 6 years. I would know; I’ve been attending this school for 6 years — 4 years of undergraduate and 2 years into this thing called medical school. Our adherence to routines and comfort in what’s predictable has brought us together, in passing, for years now.

He had a weird face. He was old. His thoracic spine took the shape of the parabolas that I familiarized myself with in the years before medical school. His stride was small. He walked slow. I couldn’t tell if he was in pain or just looked mean. Maybe I was just being weird. Everyone gets old. Before this day, six years into my library co-habitation with that one guy, I have never spoken a word to him, just passing smiles. I decided I would use these 15 minutes to do just that.

Me: “Ah, it doesn’t open ‘til 8 [a.m.] huh?”
TOG: “Nope, not ‘til 8 [a.m.].”
Me: “I see you here often. Do you work here?”
TOG: “No, I study Quantum Physics. I come here to conduct research and publish my work with a group I work with based in San Francisco.”
Me: “Oh, that’s nice. Quantum Physics is a bit out of my league. I try to stay in my lane; I settled on Medicine.”
TOG: “Is that why you’re here even though it’s spring break? The undergraduates are all gone. The whole campus seems empty.”
Me: “Yeah, we don’t really get a break. So, for me, it’s the same as any other day – bright and early at the library.”
Me: “So, quantum physics huh?”
TOG: “Yes, I’ve been studying since I graduated here in ’72.”
Me: “Oh, you were a student here? What did you study then?”
TOG: “Psychology. It goes hand in hand with quantum physics. You can’t understand quantum physics without consciousness.”
Me: “And there is no consciousness without physics.” I was trying to be friendly…

… TOG: “That’s right. It’s all about asking the right questions. The answers are right in front of you. You just need a search bar to type your question into. It’s all in the internet. At least it will be before the government shuts it down. It’s part of their deal with the aliens. They don’t want you to know what we’ve known since the aliens first arrived in 1946. Most people know about it; they just liked the world better before they knew. So, they pretend they don’t. What’s wild is that the aliens have an IQ of about 400-420, so I’m sure they meant for things to be this way. They can read your mind after all. The government should have never sent out that signal in 1945. That’s when the three extraterrestrial representatives arrived representing each of their space colonies. The government knew the aliens would take this precious planet so they attempted to build an alliance with them. They reached a deal – if we provided 100,000 humans for physical examination each year, the aliens, in return, wouldn’t take over this planet. Soon, we will run out of people to offer them. And soon, the internet will be shut down once the government feels people are noticing how many people have gone missing…”

Our conversation filled the next 15 minutes. I learned so much about not only TOG, but also myself. You’d be surprised at what you don’t know. He told me his name is Mr. Brown. I told him my name as well. Across my first two years of medical school I felt myself trying out my new skills of “developing a differential diagnosis” like a bird trying its wings for the first time. Each time I learned something new in class, I subsequently added to my differential diagnosis for TOG (Mr. Brown) and his strange, humble appearance. First, it was degenerative arthritis. Next block it was ankylosing spondylitis. A few blocks later it was Parkinson’s. But now, as he shuffled into the now-open double doors of the library, I added schizophrenia spectrum disorder. His Parkinsonian, or extrapyramidal, symptoms may simply be a result of 1st generation antipsychotic use. It took six years of examination, two years of research, and one conversation to come to this conclusion. It was a humbling moment.

I wouldn’t dare ask Mr. Brown about his medical record. In fact, I’ve given him a pseudonym and left out a few identifying pieces of information to protect his identity, and our trust. As I held the double doors open for what could be my newest friend — I couldn’t help but be reminded of the fact that everybody is somebody’s patient and you really don’t know until you know.

Aaron Watson Aaron Watson (1 Posts)

Contributing Writer

University of California Riverside


Aaron Watson is a 1st year medical student at the University of California Riverside School of Medicine. After receiving his bachelor’s in biochemistry at the same university, Aaron decided to pursue a career in medicine. Outside of classes, Aaron spends most of his free time between family, the school gym and the occasional political discussion. While these three hobbies don’t always fit together well, it’s a unique combination that keeps his spirits up in a world of high stress and demands.