Hernia schmernia

Allow me to make some generalizations.  Holden drivers are knuckleheads.  People who vote conservative are heartless and greedy.  And sturgeons are jerks.

Generalizations being what they are, many exceptions exist.  But if you keep these guidelines in the back of your head I reckon you'll be right more often than wrong.  Naturally, should you encounter a conservative voting sturgeon who drives a Holden, steer clear.  Haha - of course, this is patently ridiculous - what sturgeon would ever drive a Holden?

Anyway, you've probably figured out that I've got a bee in my bonnet about sturgeons today.  I'm sure that by next week I'll be fine, back to my normal idolization of them as suprahumans, veritable giants among us.  Which is a good thing because I'll be stuck on a sturgical ward next week so I'd better learn to kiss some serious butt.  But today I am riled up because I am sick of being patronized.

Of course, I am used to being patronized.  It happens all the time, especially when you're a newbie in a field with a staggeringly immense sense of self-importance and hierarchy like sturgery.  And to be honest I don't really much mind being patronized as long as I am actually learning something useful at the same time.  Which brings me neatly around to direct and indirect inguinal hernias.

But first, let me digress by noting that if I had a dollar for every time some smart-arse sturgeon smirked at me and said, "Oh, but you guys don't learn anatomy these days, do you?", I'd be off to the shops right now to buy some more pies and when I had, I'd throw them onto the road to be run over by trucks then I'd go back into the shop and buy some more just because I could.  I was so happy this afternoon because shortly after our instructing sturgeon unleashed this particular piece of tripe at us, he was forced to retract it after one of my Esteemed Colleague correctly named the pampiniform venous plexus.  So there!

The thing that really gets me about sturgeons harping on about this anatomy thing is that:

1. It wasn't us who changed the course, so shut up.
2. It was changed because it was a big fat waste of time, so shut up.
3. It's because of people like you badmouthing us in front of patients that I have to put up with patients asking me if I even know where their spleen is, so shut up.
4. You've got your pants pulled up so high I can see your socks, so shut up.

Anyway, back to direct and indirect inguinal hernias...  Every time (and yes, it has happened multiple times) this topic has come up in our anatomy classes (when?  in our ANATOMY CLASSES) our instructors have emphasized that it's very confusing and of no practical consequence but that we should learn it because sturgeons like to ask students questions about it so that they can prance around clutching at their chests and bemoaning the state of modern education which then gives then a further license to tell stories about how many patients they accidentally killed when they were interns working 72-hour sleepless shifts but it was all for the best because look how brilliant they are now and it was a public hospital anyway.

Where was I?  Oh yes.  I had always had the sneaking suspicion that our instructors were just bitter academics and that there must actually be some clinical significance to the direct/indirect inguinal hernia issue that they weren't aware of.  So I did my best to understand hernias, and lo and behold, I became vexed and confused.

But today when we were getting grilled about hernias by the sturgeon, after he gleefully ridiculed us for our lack of anatomical knowledge and showed us how to determine at examination if a hernia was direct or indirect, he told us that it didn't really make any difference because the treatment for both direct and indirect hernias was EXACTLY THE SAME and in fact the only real way to tell if it was direct or indirect was once you'd cut the patient open in sturgery, so the examination result was not only irrelevant, it was inaccurate.  And he sternly emphasized that we should be careful to learn the anatomy and the definitions so that we could answer the questions that other sturgeons might ask us, like he just had.  And he was deadly serious.

Perhaps I am just bitter and stubborn myself, but I fail to see why I should devote my time or energy to learning something that is of zero clinical significance solely because people higher up the food chain are likely to grill me about it on the basis that it is notoriously hard to learn.  I might as well memorize the first hundred digits of pi, or learn to recite some poetry in Greek.  What a sad indictment on the profession that this kind of crap still goes on.

Join with me, fellow medical students, and refuse to learn the difference between direct and indirect inguinal hernias.  Maybe we can get bumper stickers printed.