As part of the family medicine rotation, all students must prepare a lecture on a selected topic of disease that is commonly seen in the outpatient setting. Our speeches are supposed to be given such that a lay audience can understand material, though we’re really just talking to our classmates. We also have to create pamphlets similar to what is given out in a doctor’s office to sufferers of these pervasive illness is. You’ve probably encountered the trifold pamphlets that have a title along the lines of “Have you had your cholesterol checked recently?” The professionally created note then goes on to list all the dangers of high cholesterol, before finally telling you that you need a particular drug (as prescribed by your doctor of course). These tracts—which look eerily similar to religious pamphlets—are usually created by drug companies as a marketing tool under the guise that they are somehow educating patients.
I have been assigned the topic of vaginitis, inflammation of the vagina that is usually caused by infection. I’ve decided to throw caution to the wind and present a lecture worth giving. I imagine that it would go something like this…
The lights dim, Yanni starts playing, I light a candle and say something classy to the women in the audience like, “You look great. Have you lost weight? I’ve got a talk today that’s just for the ladies.”
(PowerPoint goes to the opening slide)
I’ll then give a definition of vaginitis and describe some of its features: erythema, burning sensation, and discharge. “Red, hot, and juicy? That sounds more like an advertisement for the Steak and Ale than it does a serious disease.”
Next, I’ll have to discuss how women get it. “Most cases of vaginitis are caused by bacteria. Women get infected with bacteria ‘down there’ by committing sin. So remember, preventative medicine is key: go to church and stay away from doctors.”
Finally, I’ll wrap up with the treatment section. To treat vaginitis doctors have to go after the most common causes. Therefore, they typically use metronidazole because it kills most of the organisms that can cause this disease. Treatment decisions are usually empirically based without confirming the presence of the microorganism. Gynecologists are handing out metronidazole like it’s Halloween candy. Like they’re donating Thanksgiving turkeys at the homeless shelter. Like they’re Oprah and giving out freebies. “You get Flagyl! You get Flagyl! You’re all getting Flagyl!”
Now that’s a lecture worth seeing.