OPINION In Memoriam
by DAVID LIPSKI , MD
With a profound sense of loss , we announce the loss of a venerable pillar of the medical community , the Physical Exam .
Physical Exam was conceived thousands of years ago , certainly of multiethnic heritage . Her growth and maturation were slow but steady , and some would say she was in her prime in the 19th and 20th centuries . In English-speaking settings , she was known affectionately as “ Physical ” or simply “ PE .” She had family in Japan in of all places the Toyota Production System , a relative known there as “ Genchi Genbutsu ,” literally , “ Go and see for yourself .” Also left to cherish her memory is a close relative , Anatomy , who is getting out less and less , as all of us know .
Those who knew her well would agree that she was helpful beyond words , literally . She never spoke , but instead left strong impressions with sight , hearing , touch and smell . Many viewed her mute demeanor as a disadvantage , but no one could argue with her success . Close acquaintances attest that the more intimately they aligned with Physical and the heavier they leaned on her , the more helpful she became . Physical was never , ever mean , but everyone understood that it took a while to get to know her . The fortunate individual who took the time to nurture a relationship with her discovered she was a loyal friend who never lied or betrayed a confidence . Instead , she often came to the rescue ,
and relieved both physician and patient with her wisdom . Her principles were simple but not necessarily easy . She was beautiful though not glamorous , and her many suitors were pleasantly surprised to discover how frugal her existence was , especially compared to what she gave in return .
In a moment of self-reflection , Physical once said her greatest regret was that she never overcame the chasm between those who said they knew her but did not , and those who were close to her , particularly among the young . Early on physicians were her most tenacious allies , having been introduced to her by her lovers in medical school . Those who never attended medical school missed the opportunity for a formal introduction , and so pursued relationships with Cut / Paste , Template and Ancillary Testing . At least at first . In later years , she was only occasionally asked out , even by physicians . “ Oh sure , I had tons of biographers writing about me ,” she lamented once . “ But hardly anyone really paid attention to me .” This accounted for her infrequent public sightings in recent years . Her favorite Bible passage was Revelation 2:4-5 .
Physical Exam is survived by an oft-changing cadre of modalities , including Ultrasound , Scintigraphy , Computed Tomography and Magnetic Resonance Imaging , to name a few . Left to inherit her estate is Specialist Consult . The list is so impressive , yet we are left to wonder whether there will ever be another like PE : so available , inexpensive , reliable , reproducible and trend-able . Instead of a formal service , she asked that she be remembered fondly as a loyal friend who just wanted to help everyone .
Dr . Lipski is a practicing vascular surgeon in Louisville .
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24 LOUISVILLE MEDICINE OPINION