Acronyms

CAGE. This is one of the many, and most simple acronyms we've learned thus far. Medical school is full of them. To pass anatomy, you need to know a great deal of acronyms, when taking a patient history you use a number of different acronyms, and in almost every course we will be learning and using multiple acronyms. The amount of information stored in a short list of letters is amazing. For example, OPQRST, which is used for pain (Onset - when it started, Position - where it hurts, Quality - what does it feel like, Radiation - does it go anywhere else, Severity - scale of 1 to 10, Timing - when and how long it hurts and what makes it better or worse), can help you remember to ask all the necessary questions when creating a patient's History of Present Illness (HPI) and give you enough information to establish a Differential Diagnosis (DDx).

We were learning about mental health assessments in our class on Patient Interviewing/Physical Diagnosis when alcoholism came up. The first thing we were told was a joke:

When in med school, how do you know if a patient is an alcoholic? - They drink more than you do. Ha. Yep, we all laughed or chuckled.

Next, we learned CAGE - Cutdown, Annoyed, Guilt, Eye-opener... (C - If you've considered or tried to cutdown on drinking, A - if others are annoyed by your drinking habits, G - if you feel guilt after drinking, E - if you need a drink in the morning). If two of these criteria fit you, you might be an alcoholic. What does that mean? I almost started to laugh because I knew most of us in the room had experienced at least 3/4 of the criteria, which would lead some to think, "You must all be alcoholics... or at least functioning alcoholics!"

That is when you wonder about "criteria" for diagnoses. As a healthcare provider, It is important to have a line to draw serving as an objective baseline and reference. It is also important to use subjective judgement because it is pretty clear that the group of us in class are probably not alcoholics, even though the "criteria" says we might be. It is instances like these that are quite sobering. We remember that medicine, is not a perfect science, and it is not all about data and objectivity. It is called "a medical practice" for a reason, because like all other things related to humanity, medicine is flawed and we are always trying to improve ourselves.

Now, time to grab my laundry out of the dryer...