So far, in the competition for most important phrase of third year, the clear favorite (running away with it, really), is just three little words. But they’re more meaningful than anything in Robbins, Goodman & Gilman, Harrison’s, or any other tome on my bookshelf. Without further ado, the most important three words of Third Year are:
I DON’T KNOW.
The period at the end of the sentence is sometimes omitted, often replaced by a comma, as in “I don’t know, but I think it might be Lupus again.” This is a bad thing. The comma nullifies every ounce of meaning those three words could serve. Instead, let that period linger for a minute in the air. Give it the full beat that it deserves. Let it fully modulate what you plan to say next. Maybe that time will be useful to you in composing your reply. “I don’t know. [PAUSE] I’m concerned that your Lupus might be flaring up.”
Now, on rounds, this sentence is often sheathed, and many hasty uncertainties are thrown about with false confidence. References to journal articles, Up-to-Date, and past grand rounds are more palatable than the simple truth. This is fine – rounds can require some gamesmanship, and as a student you often feel exquisite pressure to play according to the rules set before you.
In more informal settings, with other students, a more obscene cousin of this phrase can often be found. That is fine too, it has its place.
Don’t ever forget that you are a student of medicine. Despite what others may say about you, and despite any degrees, awards, or titles you may receive, you will always be a student of medicine. And, although you will try, you will never know everything. Act accordingly.
So, please, for the sake of all that is holy, don’t ever walk into a patient’s room without those three words at the ready.