the marvin principle

my favorite rotation in residency was pulmonology.  i don't really know why, what with all the phlegm it involved, but i just liked that service.  there was one man we admitted again and again for exacerbations of his severe emphysema.  his name was marvin (not his real name of course).  marvin had really bad lungs, but a really great personality.  no matter how short of breath he was, he loved to talk.

what typically happened was this.  you would get a page from your resident telling you to go down to the ER and admit marvin.  the ER knew him well, so their notes were usually pretty brief.  but you, being the diligent intern that you were, would proceed to take a detailed history from marvin.  you would spend a great deal of time asking him questions and listening to his answers.  after you'd examined him,  you would hunt down your resident to present marvin to them.

and that is the point at which you would realize that marvin had not answered even one single question you had asked, like when did his symptoms start, or did he have blood in his sputum.  you were bewildered.  he seemed to be answering you.  what had he actually said?  you had absolutely no idea.  we called it the marvin principle. the more he talked, the fewer facts you actually gathered.

when i was the resident, i never warned my interns about marvin.  the look on their faces when they tried to present marvin's story to me was just too much fun.  exactly when did his symptoms begin?  they had absolutely no idea.  marvin died of stomach cancer, but i still smile when i think of him.