Past and Present

I went to a meeting this week and confronted my past. I went to see if I could learn anything new about electrocardiograms. The room was full of internists of all ages. Most were there for a final cramming session before they took a test that would supposedly pronounce them competent at reading tracings, or not. This test, it seems, would ensure their continued ability to bill for electrocardiogram interpretation.

Several smart young cardiologists filled the hours with a mix of fact and impression. With computerized slide presentations and laser pointers, they talked about how an ST segment's appearance indicated ischemia or injury and whether the ST segment was nonspecific. They listed the criteria for hypertrophy of each chamber and for distinguishing between supraventricular tachycardia with aberration and ventricular tachycardia. They told us how to tell pericarditis from early repolarization and how to tell artifact from reality. They were smart, efficient, and often funny. And …