A Country Doctor Writes:

Rummaging through medical textbooks and notebooks from medical school in my library the other day I rediscovered a compendium that I had almost forgotten. I was one of the editors of this 256 page down and dirty guide for what to do when starting your internship. After I moved to this country, I learned that there already was such a book over here, called the Washington Manual. But back in Sweden in 1979, I was one of the editors or what we should have called the Uppsala Manual.

In Sweden, you can work as a physician, although under supervision, during the last two years of medical school and many of us had done that in different specialties. I had worked in nursing homes and in urgent care. My urgent care shifts were in a side wing of a small emergency room a short distance from Uppsala, where I lived. My shift started Friday 6 PM and ended Monday morning 6 AM. The triage nurses would decide which patients needed to see the emergency room for all the services they offered and which patients could be seen in the urgent care clinic next to it.

I loved that job.

Many of us in my medical school class got together to create an intern’s pocket size reference guide for what to do in common situations. This was based on what we learned in medical school and what we learned in our early practice positions. After I moved to this country, I found that there were a few similar books published by commercial publishing companies here, but there was no such thing available in Sweden when we graduated from medical school in 1979.

Looking at this book today, there are some striking differences in approach, partly based on evolving understanding of disease processes and also, of course, because of new imaging possibilities and new pharmaceuticals to treat disease.

In a future post I will give some examples that may seem quaint or even odd reading them now, 45 years later.