Stubby is in the house. I believe his real name was Dr. Stubblethorn or something similar. Old english stock with a highly expressed eccentricity gene. His main preoccupation was heart sounds and there was nothing more interesting in his world than a rheumatic heart. It was a shame, in his view, that there were only four valves to muck up. It was said that his stethescope had three heads, and if you were to cut off one of them, two more would grow in it's place. Generations of med students were entertained by his imitation of heart sounds. In fine form, he could simulate more snaps, pops and clicks than a flock of starlings in a feeding frenzy. And he was now on the cardiology consultation service.
Generally that was cause for celebration because not only was he highly entertaining, he was so genuinely fascinated by anything noisy that pointing him towards any heart that could still produce a beat or two would send him off into an ausculatory revery that would distract from any shortcomings the service might want to hide. But this time it was different because he came armed. He had now in his possession something called a phonocardiogram. Apparently it was an apparatus of sorts that could amplify and record heart sounds. This would make sorting out the many different murmurs and thrills so much easier.Debate over such matters would come to an end. But what about the S3? Surely he didn't want to surrender his absolute power over the S3, for after all, Stubby was the supreme judge of the matter. If he said an S3 was present, there wasn't a sole on the continent who could say otherwise. More importantly, how could housestaff discipline be maintained without the hierarchy preserving ambiguity of the S3? Did he expect us to return to spleen tip palpation?
This was a clear and present danger that required swift action. Though there was no meeting, no collusion amongst residents, a consensus evolved and a simple, precise response. We never ordered the test. Though the technology apparently existed, nobody seemed interested in finding out if the S3 was out there. Nobody seemed to think it's importance warranted confirming it's presence or absence. I never once heard "phono stat, might be an S3!" The world could apparently continue to thrive in uncertainty because the phonocardiogram subsequently slipped into oblivion. I sometimes suspect that even Dr. Stubblethorn was glad to see it go.
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