My desk drawer I’m starting to clean
These papers, how long has it been?
The stuff in the files
So old it brings smiles
And tell me, what does it mean?
Back in 1979, in the first week of medical school, they taught us that truth had a five-year half-life. Which meant that half of what we learned then would be incomplete, out of date, or downright wrong in five years.
Anatomy and human nature stayed pretty much constant, but time invalidated much of the rest. The rate of change of medical information has accelerated, and five years now seems optimistic.
Today I opened my desk’s file drawer to start to throw away files. In 1987 a doctor had to maintain a filing system; you would read an article in a journal, tear it out of the magazine, and file it away. With the advent of good search engines and online medical journal access, I haven’t used my file system in a very long time.
I’ve chucked outdated information on syphilis, seizures, and suturing.
There was the Boston Fever Study I participated in that looked at medication for fever in infants; I kept those papers but haven’t touched them for almost twenty years. Nor have I participated in a large-scale research study since.
I did two studies of my own, and I’ll keep those papers. One had to do with hereditary coproporphyria (a supposedly rare blood disease) in adolescent conduct disorder. I never published the results. But I’m not going to trash the notes.
The other study had to do with 20 consecutive patients who came in with no other complaint than not feeling good. Forty percent of them came up with a treatable diagnosis.
I had done the study because I was concerned at the cost of the laboratory work I was ordering. In the long run, the expense was well justified.
I still have to face my files entitled CALL NOTES and SEPARATE PATIENT INFORMATION.
I used to keep a written brief note on all the phone calls I got over weekend call. Now I do the same thing electronically.
But the information carries historic interest, it shows who practiced at various times, and what concerned people. And I wrote it on the back of the computer printout of the hospital census.
The SEPARATE PATIENT INFORMATION file contains the information that patients didn’t want in their written file. I wrote most of it because they didn’t want the transcriptionist to know what we’d talked about. Inside that Manila folder seethes a maelstrom of human drama and irony, tales of betrayal and lust.