Imaginary illnesses afflict aspiring doctors

Second-year students affected during studies of pathology

January 21, 2001|By Liz Szabo | Liz Szabo,KNIGHT RIDDER/TRIBUNE

NORFOLK, Va. - An epidemic has been sweeping Eastern Virginia Medical School - one that seems to produce different symptoms in every sufferer.

Second-year medical student Rodney Sturgeon had a stiff neck, one of the telltale signs of meningitis.

Alexandra Carleo thought her spleen was tender, a portent of leukemia.

And then there is poor Riz Ahmed. This guy is sure he's suffering not only from apparent lactose intolerance, but possible diabetes as well.

Doctors gave them all the same diagnosis: med student's disease, alternately known as Second-Year Syndrome.

The imaginary illness afflicts just about all aspiring doctors. It most often strikes during the second of their four years of medical school, when students are immersed in such subjects as pathology, the study of disease, and microbiology, the science of scary and squirmy germs found in petri dishes and medical students' kitchen sinks.

Dr. Christine Matson has seen it all before - and even once suffered from a mild case herself. Matson, an associate dean for education, treats medical students as one of the physicians at Ghent Family Practice.

Easy to understand

"You can tell what they're studying in pathology because that's what they're coming in thinking they have," Matson said. "They'll come in with a swollen lymph node, which for most people will mean a sore throat. But they've just studied oncology, so to them it's lymphoma."

It's easy to understand the source of this malady, said Dr. Nancy Fishback, an associate professor of internal medicine who's teaching a pathology class this semester.

Students cramming for exams immerse themselves in all sorts of afflictions - helicobactor, pinworm, toxoplasmosis, even African sleeping sickness. They're drilled again and again on their ability to piece together a thin string of mystifying and often conflicting symptoms.

To make matters worse, Fishback said, students really do experience a lot of the symptoms they study. Especially fatigue. Especially headaches. Especially during final exams, which began last week.

`I was just joking'

"I didn't really think I had meningitis," Sturgeon said, grinning over the viewfinder of his microscope in a second-floor classroom of Lewis Hall and avoiding eye contact. "I was just joking."

His lab partners didn't believe a word of it.

"Oh, you did so," said Kara Nuss, a fellow second-year. "He was so concerned about it."

When pressed, Sturgeon admitted that he might, in fact, just possibly have mentioned it to a doctor. Casually. Not like he really believed it. Just sort of posed it as one of several possible explanations for that stiff neck.

"The doctor said when she was a medical student, she thought she had schizophrenia," Sturgeon said.

Not that his pal Nuss is immune.

She had two PPD tests to screen for tuberculosis.

But Nuss, like so many medical students who care for patients with infectious diseases, had a genuine cause for concern. She had just visited a South African mission clinic and had sat on the bed of a tuberculosis patient without wearing a mask. None of the other doctors were masked, either.

Ahmed, working on a slide at the next black lab table, is sure he has a good reason to fret about diabetes. It runs in his family.

"I really think I have diabetes," Ahmed said, nodding his head vigorously to convince the three women sharing his table and ticking off a long list of classic symptoms. "I'm always thirsty. I'm always going to the bathroom. Also, and I don't know if this is just medical school or it's lactose intolerance, but I've been having bowel trouble."

Just how long, the future physicians at his table ask him, has Ahmed been experiencing bowel trouble?

"Just since I started medical school," said the native of Bangladesh. "Actually, especially after we started studying lactose intolerance. No, no, I really think I have it. It affects a lot of Southeast Asians."

As a med student, Ahmed stays up late every night to study, sometimes skipping meals, other times scarfing down junk food. It's enough to suppress anyone's immune system, he said.

Has he seen a physician? his classmates ask.

"If I end up in the E.R.," he said, "I'll have a blood test done."

Ahmed's colleague across the table, Alexandra Carleo, also recently wondered if her days were numbered. She and some friends began suffering from mysterious pains at the same time.

Could it be leukemia?

Carleo had pains in the upper part of her abdomen, near her spleen. Could it be leukemia?

A male friend had pains in his chest. He couldn't help but think about pneumonia. He even went to the doctor.

A third friend finally pieced it all together: They weren't dying. Their muscles ached because they had strained seldom-used parts of their torso while practicing their golf swings on a recent outing.

"My friend said to me, `You idiot,'" said Carleo, who began pathology class by feeling a preserved specimen of a cancerous esophagus through latex-gloved hands. " `You're just sore.' "

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