Pimp Class

One scary aspect of medical education is the practice of "pimping." It's sort of like approaching a car pileup at 80 miles an hour. Time slows to a crawl. You know that the collision is going to occur, yet there's nothing you can do to avoid it. It's intimidating, but when done correctly, can serve as a valuable teaching tool. Or, it can serve as a means of humiliation. Either way, most of us medical students dread being pimped - it's never comfortable looking like a fool in front of your peers, even when you know that they're watching you, rooting for you, scared that the next question is coming for them.

I recently sat in on a lecture about genetic disease, and the lecturer, "Dr. Gabriel" is known to have these interactive discussions. You can't fall asleep in these classes. Dr. Gabriel likes to go around the room asking question after question:

Dr. Gabriel: What are some findings in a neonate born to a mother with poorly controlled diabetes? You!
Med student #1: ....Hypoglycemia?
Dr. Gabriel: Good! Next?
Med student #2: Macrosomia.
Dr. Gabriel: Next!
Med student #3: The baby is large for gestational age?
Dr. Gabriel: Right. Next?
Mikey: Uh.................
Dr. Gabriel: Nice try. Anyone else? Anyone?...Bueller?...Bueller? How about birth defects? Lesions in the cardiovascular and central nervous systems?

Argh. I dropped the ball the first go-round. Part of the problem with these questions is that 100% of the people in the room know at least one of these complications. Probably 95% at least two complications, et cetera. Most students probably wouldn't be able to name every single characteristic, especially in a topic so broad. We just try to hit the high yield stuff at this point. So anyway, the closer you are to the beginning of the line of people answering a given question, the better your chances are for getting an answer correct. As fate would have it, I did not have this luxury on the next round of questioning. But I had a fighting chance:

Dr. Gabriel: Okay, next question - give me a midline anatomical structure and a developmental abnormality in that structure.
Med student #16 (see, I'm going in reverse now, indicating that Dr Gabriel is starting on the other side of the room): The stomach?
Dr. Gabriel: The stomach isn't really midline. Next!
Med student #15: The head of the pancreas. Annular pancreas. (Ooh, good one).
Med student #14: The mouth. Cleft lip and palate. (Hrm, an easy one.)
Med student #13: The heart's pretty midline, right?
Dr. Gabriel: Are you SURE?????
Med student #13: Um....yes?
Dr. Gabriel: And the abnormality?
Med student #13: ....Ventricular septal defect? (Another easy one off my own list).
Dr. Gabriel: Next?
Med student #12: The brain. Hydrocephalus.
Dr. Gabriel: Wrong! Hydrocephalus is not really a midline abnormality. Think of a midline brain structure.
Med student #11: The corpus callosum? Agenesis. (Yikes, another good one. The list is getting shorter, and my turn is coming. I've got two solid answers, though).
Med student #10: The trachea and esophagus - tracheoesophageal fistula. (Argh. My list is shrinking fast.)
Med student #9: The spine. Spina bifida. (Dammit! One last answer on my list.)
Med student #8: Dammit! He took mine!
Dr. Gabriel: Too bad. You?!

(Well, I'm sorry. But I'm going to have to whip this out.)

Mikey: The penis. Hypospadias.
Dr. Gabriel: Excellent!
Mikey (aside): Sweeeeeeeeeeeeeeeeeeeeeeeeeeet.
Med student #9 (to Mikey): You perv.

Well. Despite now being thought of as some sort of sexual deviant by my peers, I can call this round of questioning a success. Some phrases spring to mind: Grace under pressure, courage under fire, clutch hitter, etc. Will I come through again? Tune in next time when I go through one of my preceptor evaluations.