EMRs and iPads may come and go, but I can count on one thing. I realized this last week, when I walked into a couple exam rooms without it. I felt suddenly naked and out of sorts when I entered the exam room whitecoatless. Yet it was not the lack of uniform that flustered me, but rather something more important – believe it or not – than a CT or MRI. It assists my judgment and corroborates hypotheses in a few minutes. It makes the difference between life and death at times. It is often used to help confirm time of death, in fact.
So basic and resilient is this trusty sidekick that I have underappreciated at times, having recently fallen under the spell of such things as healthcare communications and social media, iPads, and other expensive pursuits/gadgets. Perhaps a bit of technology and information overload has led me to suddenly appreciate the most “primitive” aspects of my profession, which have been so taken for granted that I was completely unaware of it’s unavailability in other countries.
I speak, of course, of my stethoscope.
I got mine at the start of my focused medical training. Somehow, it was slim pickings at the medical school bookstore at the beginning of the year. I was left with one of a color that was less than appealing to me, thinking I would, perhaps, replace it when I became an attending. It was quite a steep purchase for a student living on loans and Rice-a-Roni. But it has given me MANY returns during our thirteen years together. And I have not swapped it out for another color (though I have contemplated adding some “bling” to it, ultimately scrapping the idea due to a realization that it would be quite a hassle to clean).
My boring green stethoscope, in fact, has helped me through codes on the hospital wards, alerted me to carotid stenoses, confirmed suspicions of fluid on the lung, gave me evidence of pericarditis, and even doubled as a reflex hammer. In the age of expensive disposability, my stethoscope has only needed to have its earpieces replaced once. And I might have to do it once or twice more in my clinical lifetime. I do not even know if one of these things can actually be broken. It also has not yet been replaced by a flashy fad. Does anyone really need to upgrade their stethoscope?
My stethoscope is my constant companion, even when I am evaluating a rash. (You never know what you run into primary care, after all). It is the workhorse of medicine, undervalued and underappreciated, much like primary care today.