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How to cite this article: Muhammad Saaiq. MEDICAL STUDENT’S DISEASE (MSD): A FACT NOT FALLACY.

Cenna, Khyber Medical College Peshawar 1998.

TITLE: MEDICAL STUDENT’S DISEASE (MSD): A FACT NOT FALLACY AUTHOR: MUHAMMAD SAAIQ 4th Year MBBS, Khyber Medical College, Peshawar muhammadsaaiq5@gmail.com

Medical student’s disease (MSD) is an interesting but miserable phenomenon that has long been experienced by medical students. Every medical student owes the risk to suffer from this condition. The risk peaks particularly in the fourth and final year classes where diseases and pathologies become the main topic of discussion in lectures and ward rounds.

What happens is that after studying the symptoms and signs of an illness, the medical student starts thinking that these features are characteristically the same as those of his own, so diagnosing himself as a sufferer of that illness. Most often there is a narrow margin between physiological and pathological phenomena within our body; that’s why a medical student can easily jump to the conclusion that he has the same features that characterize a given serious illness. This is especially true for psychiatric illnesses. We all in our daily life experience a wide range of fluctuations in our moods, emotions, feelings, behavior and subjective experiences. Our mind often jumps between happy and sad states. At times we are quite happy, satisfied and hopeful with our minds remaining sharp, keen and interested in work. Nevertheless it is not unusual to feel unhappy, indifferent and anxious on other occasions. In fact, it is the persistence, intensity and consistency of such feelings that determine normal as well as abnormal behavior. If a person has been

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previously certain about the normality of his behavior and health status then it is quite unlikely that reading about others’ diseases may prompt him to think that he himself is a sufferer of the same conditions. Owing to the common and vague features which many diseases share, one may easily apply many diseases to his own. The health consciousness among medical students is also an important contributory factor that may prompt a student to re-evaluate his health status. During the last four years of my medical school, I have seen several interesting cases of MSD. I want to share my experience with my readers in the following. We enjoyed our first day at the college with a scholarly opening lecture on AIDS by the then college principal. At that time we the blank new entrants couldn’t understand the much advanced medical terminologies and could only follow common features such as weakness, weight loss, night sweating, loss of appetite, fever and diarrhea etc. For the same reason we linked AIDS to the same symptoms. After having attended the

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lecture, one of our colleague, in a very sad tone told me that he was surely a suffer of AIDS because he experienced some weight loss, night sweating, and low appetite. The guy was especially anxious because he had the habit of masturbation and the lecture had given us the impression that sex and AIDS go hand in hand. It was only after several years when that guy gave up that idea and became a healthy person because by then he had acquired adequate knowledge on the subject. Diseases of the thyroid gland are very common in our settings and our teachers lay special emphasis on these diseases while teaching endocrinology. One will be

astonished to know that after attending lectures on the thyroid hormones, hyper and hypothyroidism, many of our class-fellows rushed to the medical outpatients department with self-perceived signs and symptoms as the sufferers of hyper and hypothyroidism. Universal student’s problems; which are mostly nonexistent in true sense but students are often captured by them, (such as lack of concentration, drowsiness, lethargy in study, dull

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memory, lack of interest in college work etc). are such vague symptoms which can be true of any one and everyone. Thus under the Barnum effect any student can be under the false impression that he is hypothyroid. Another group of students may accept symptoms like fatigue, exhaustion, increased sweating, insomnia, mental disturbance, and diarrhea etc. as valid description of their personality, thus diagnosing themselves as hyperthyroid. In such case the student’s prejudice may reach to such a degree of firmness that the clinician if not very careful in history taking and making his own observations, may erroneously label these MSD sufferers as actual patients. Once when I was third year student, I was travelling to my hometown on weekend. I was accompanied by one of my colleagues. Unfortunately when he was entering the vehicle, he accidentally hit his head against the roof, producing a loud tuqq. The passengers already seated there asked him to see if there was any bleeding from his head. Fortunately there was no bleeding. On the same day we had attended a forensic medicine lecture in which

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intracranial hemorrhages were discussed. From that lecture we had come to know that extradural hemorrhage usually occured after head trauma in young adults while it didn’t occur in children and elderly individuals because of the strong adherence of their dura to the skull. My friend was worried that he might have torn his middle meningeal artery, thus developing an extradural

hematoma. On the next day morning he met me in college, telling me that he felt a little drowsy and was therefore a sure case of extradural hemorrhage. I then accompanied him to the surgical outpatient department where his examination was undertaken by a competent surgeon. The patient had no history of vomiting, unconsciousness or other signs of meningeal irritation, so the surgeon paid him a smile, telling him in a funny mood that he was a medical student and had to encounter many more hemorrhages till he become a complete doctor. Once we received a case of varicocele in surgical outpatient department. Our teacher told us that in this

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condition the scrotum felt like a bag of worms. The next morning one of our batch-mates spoke me in whispers that he had palpated his scrotum and experienced a bag of worms like sensation, therefore he had varicocele. He also told me anxiously that he was afraid of becoming infertile. That intense feeling rushed him to the surgical outpatient department, but he turned out to be absolutely normal without any varicocele. After reading gastrointestinal pathology, one of our hostel fellow became a suffer of recurrent appendicitis but after examination and investigations it proved to be a case of MSD. A few months back, our pathology professor took our class test in parasitology. All our friends gave a thorough read to parasitology and not surprisingly two of our friends came up with the view that they had some worm infestations because they ate more and still didn’t gain weight. Labored under this prejudice they tested their stool and blood but couldn’t justify their false perceptions.

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CONCLUSION: These are just a few cases of MSD which I myself have seen in a short duration of four years. The iceberg phenomenon should be kept in mind-----surely there are many other cases of similar nature hidden in our medical student community. Indeed any medical

student can be a case of MSD at any stage of his life. Of course medical students are the worst patients and clinicians should be very careful and shrewd in talking them.

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