Posts Tagged ‘stress’

At the beginning of the year there was a joke that everyone in our class would become a hypochondriac by the end of the year, and at that time everyone laughed. I did too. I thought I was immune to those thoughts. I didn’t even make it to the end of our second block.

I suppose it has something to do with the fact that as a medical student, the vague symptoms of fatigue, malaise, and anxiety are par for the course. Do you know what the differential diagnosis for fatigue, malaise, and anxiety includes? Let me just say that it encompasses every organ system and every type of illness. Fatigue? Boom, diabetes. Malaise? Boom, HIV. Anxiety? Boom, Lyme disease. One of my preceptors once said, “If you’re convinced that [you] have something, you will see the symptoms fitting into a meaningful pattern that may not actually be there.”

It certainly doesn’t help that every day we are shown pictures of the worst possible outcomes – flesh eating disease after a paper cut, or deafness and meningitis from kissing your girlfriend. Another issue is when they tell us the proportion of the population affected by a given disease. When they tell us that more than 1 in 4 people in the world is infected with a particular type of parasitic worm, we tend to wonder which quarter of the class is carrying it.

Then they tell us about the asymptomatic carriers. Those individuals that oh so generously spread around a disease, never knowing that they leave disaster in their wake. To be honest, I recently found out I may be one.

Part of our learning experience is to practice the lab tests that are routinely performed in diagnostic medicine. A week ago, we swabbed each other and did gram stains and cultures using those swabs. This week we got our plates back, rich with natural nose and throat flora. But – horror of horrors – my plate showed evidence of beta-hemolytic colonies. For those of you that may not know what the heck I’m talking about, beta-hemolysis is the process where some bacteria may break open red blood cells on a blood agar plate.

This is usually a fairly clear indicator of Streptococcus pyogenes – the bacteria that causes strep throat. It can also cause toxic shock syndrome, impetigo, and scarlet fever. You know how I mentioned flesh-eating disease a little while ago? Yeah, S. pyogenes does that too.

So now I sit here, freaking out about the scratch on my arm and the bacteria in my throat. I wonder if I’m part of the 25% with intestinal parasites. I worry that I’m the reason my fiancee has been sick for the last week. I’ve gone through more Polysporin, Bactine, and straight up rubbing alcohol in the last month than I did during my entire time in grad school, and I have seriously considered asking my pharmacist for every single anti-parasitic he has. I have dreamed about parasites and infections, and wake up still fatigued and full of anxiety.

I wonder if the fatigue and anxiety are symptoms of anything…?