Perception is a symptom

Perception is a symptom
and living a sign of life

    table crumbs—
    embarrassing stain—

Acumen comes easily
but auscultation diligence

    crescendo-decrescendo murmur—
    tinkling of metallic bowel—

Sensation appreciates a petal
but inspection sharper thoughts

    hidden bruise—
    malignant cell—

I am a lung pumping oxygen
from here to there
My microscope— too large
for all this life

1. Medical School in the U.S. – typically is four years with the first two years spent studying the basic sciences and the last two years immersing in the clinical realm. Residency can range from three to five or more years; with fellowships after that ranging from one to three to more years as well.
2. Aortic stenosis – Classically, AS presents with a harsh, crescendo-decrescendo murmur heard best in the upper-right intercostal space. The murmur may radiate to the carotids and you may notice “pulsus parvus et tardus” (diminished and delayed carotid upstrokes). It is most commonly caused by age-related calcification. Untreated, it can cause heart failure symptoms.
3. Small bowel obstruction – If you auscultate the abdomen and hear tinkling sounds as if drops of water are hitting an empty metal bucket, you may be hearing an SBO. An SBO causes abdominal pain and inability to pass flatus and stool; with severe cases requiring surgery.
4. Screening tools for intimate partner violence – The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians screen women of childbearing age for intimate partner violence (IPV), such as domestic violence, and provide or refer women who screen positive to intervention services.
5. Prevalence of cancers – According to 2014 U.S. data, the lifetime risk of developing cancer for men is: 39.66% and the risk of lifetime risk of dying of cancer for men is: 22.03%. For women, the respective risks are: 37.65% and 18.76%.
6. Primary care physicians – can improve mortality from cancer. “Women who had 5 to 10 PCP visits had 0.69 times the odds of breast cancer mortality (95% confidence interval, 0.63-0.75), 0.83 times the odds of death from any cause having been diagnosed with breast cancer (95% confidence interval, 0.79-0.87)”