Why I Love ID – Dr. Nicolas Cortes-Penfield

What about ID makes you excited?

I love a good medical mystery or diagnostic challenge.  Infectious disease specialists are often the experts other physicians turn to when they’re stumped by a patient’s seemingly inexplicable symptoms – a persistent fever, a perplexing rash, abnormal bloodwork that hints at inflammation in the body no one can seem to track down.  As a kid who grew up listening to Car Talk on NPR and wondering at how the two hosts could make diagnoses over the phone that other mechanics had missed in person just by getting a good story, that aspect of the job really resonates with me. I still find making tough diagnoses that have frustrated patients and their doctors immensely satisfying.

I also appreciate that Infectious Diseases gives me the opportunity to move though all of the different domains of medicine.  By that, I mean that the ID team may be called to see patients in the Emergency Room, on the post-operative surgical ward, in the ICUs, in Labor & Delivery, or anywhere else, sometimes all in the same day.  We get to interact with all of the various other types of clinicians – hospitalist, medical and surgical specialists, radiologists, pathologists, laboratory microbiologists, pharmacists, nurses, etc – and rather than focusing on a single organ system and a handful of diseases we’re challenged to consider the whole patient and the full spectrum of medical illness.

Finally, I love that the keys to challenging ID cases are often in the social history – that is, in asking the patient the sorts of questions about their lives that are too often curtailed in the bustle of modern medicine. That means that part of doing my job well is spending the time to uncover the unique and more interesting sides of my patients and having the opportunity to develop a bit of a relationship.  Do you volunteer at the zoo and clean the cages in the rodent house?  Did you live in the Middle East for a year overseeing an oil pipeline construction project? Did you vacation in the rainforests of Borneo and sleep outside on the dirt?  Did you eat raw bear meat, unpasteurized cheese, or a live snail?  Please, tell me all about it!

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