(Or Medical Student Syndrome, which does not appear in the DSM V.)
The ten of us were alternately making faces of concentration and resignation as we palpated for each other's lymph nodes. Dr. Schmitz was leaning against the wall in the corner of the room, holding a paper cup of coffee beneath his nose and staring at the carpet. Slouched over, he was still a few fingers taller than the life-sized plastic skeleton beside him, whose crooked halluces dangled several centimetres off the ground.
Aditi's sudden gasp made us all turn our heads, and the room was silent. She and Andrea were sitting in the far corner of the room, each looking at the other with wide eyes. Andrea kept her hands near her chest as if she had withdrawn them from a flame, and was fearfully looking from one face to the next. Aditi was running her right index finger back and forth along her left supraclavicular groove, her eyes fixed on Andrea. Dr. Schmitz had set his eyes on Aditi, but otherwise had not moved. She turned to him and quietly said, "Is this Virchow's node?"
Dr. Schmitz carefully placed his cup on the bench and pushed himself off the wall. He rubbed his wiry hands with alcohol gel and stepped over to stand behind Aditi, while we all stared. A few of the boys sat shirtless on the benches, looking past the others who had been examining them. In his usual style, Dr. Schmitz looked at the ceiling as he palpated each set of nodes in succession, moving his hands slowly and making light, rapid taps with the pulps of all eight fingers along Aditi's skin. It was a style that none of us had adopted, instead choosing to rub the skin in small circles. Beginning with his hands together beneath the chin, he said, "Submental... submandibular... pre-auricular..." as if playing a miniature piano along Aditi's neck and temporal bones, "post-auricular... de jugular chain... de posterior triangle... occippital... and supraclavicular," finishing with one hand at the medial half of each clavicle. With his left hand he paused for a second over something he seemed to have found, before shrugging and stepping away.
"Eh, it seems a bit enlarged, yes."
Aditi turned and leaned in close to Andrea, with both hands covering her mouth. In a hushed, high-pitched tone she said, "That's like a fifty percent chance I have cancer!"
A few of us rolled our eyes and Dr. Schmitz turned to face the room as he said, "Now dis is exactly what I have been talking about when I say normal variants. Yes, yes, I know in Talley and O'connor it says, 'Oh, Virchow's node points to cancer,' but dere is no such thing as a conclusive sign. You will start by looking for a collection of symptoms and signs. So let's say you have a patient who has some lymphadenopathy, well so what? Big deal. But when you see weight loss, decreased appetite, abdominal discomfort, and now suddenly an enlarged Virchov's node, den you might think, 'Hold on, dey might have de cancer, I'd better check dat.'"
Again to Andrea, now rapidly and with rising panic, Aditi said, "Oh my God, I have all of those! I've had this stomach ache all week, and—"
Now ignoring Aditi completely, Dr. Schmitz continued, "But dat's one reason why we want you guys to be examining each other, to see what is normal but also try to maybe see some normal variants."
"—lost five kilos last month!"
Almost whispering, Andrea said, "But haven't you started running again?"
"Yeah but that was only like three weeks ago! I started losing weight before that, and—"
Dr. Schmitz looked up at the clock, then turned to walk back to his coffee and his place at the wall. As he was stepping over and resuming his previous stance, he said, "So dere's not so much time left, but make sure you all have a chance to practise palpating de axillary nodes. It's a bit unpleasant, yes, but dere's a box of gloves over here and it's one place a lot of people forget to check. OK?"
“—and she had breast cancer when she was only 35, like her—”
Dr. Schmitz sipped his coffee and stared into the cup. As half of us each put on one glove and the other half each raised one arm, Scott continued worrying about his hyperthyroidism, Joanna her insufficient liver, Oliver his Kleinfelter sydrome, and Michael his systolic murmur.