Renal struggles

It was a lovely break, but I am a bit relieved that this week teaching finally resumed at the MSc Internal Medicine, University of Edinburgh. And what better topic to begin with than my sworn enemy – nephrology. Don’t get me wrong it’s not that I don’t like it – well to tell the absolute truth I don’t, but it’s not what you think.
Renal medicine has a notorious reputation for being difficult and complex – even in medical school I dreaded everything from renal physiology to clinical nephrology lectures. The field is riddled with overlapping diagnoses, vague symptoms that can point to anything or nothing, and complex treatment regimens. I like to think that in all other branches of medicine, I can think of a single most likely diagnosis given only the patients signs and symptoms (in most cases). In renal medicine, however, I find myself stumped without an array of complicated investigations (which sometimes – who am i kidding – most of the time, leave me even more confused). Everything affects the kidney and the kidney affects everything – nightmare.
Sometimes I ponder upon whether I dislike nephrology or it dislikes me. I find it interesting that people often say that they fancy nephrology for these very same reasons. But I don’t get it – not at all. That being said, the past week went a lot smoother than I expected – we dealt with some of the more common aspects of renal medicine through a tutorial and a series of lectures. I’m proud to say this week left me feeling a little less resentful towards the kidney and its intricacies. Next week is cardiology by the way (yay!).

Complexities

A clinician is complex. He is part craftsman, part practical scientist, and part historian.

A quote by Thomas Addis, a pioneer in the field of nephrology who was born in Edinburgh and studied medicine there, as well as at the Charité in Berlin. One of his major contributions to clinical medicine was his emphasis on examining patients urine both with the naked eye and microscopically – which is now standard practice.