In the context of human evolution, a vestigial organ is defined as one that has lost all or most of its original function through evolution. Charles Darwin provided a list of vestigial human organs in “The Descent of Man,” including the muscles of the ear, wisdom teeth, the appendix, the coccyx, body hair and the semilunar fold in the corner of the eye. If you had told me 19 years ago when I graduated from medical school that I would one day compare my stethoscope to a vestigial organ, I would have smiled politely and discounted everything you subsequently said. But back then, beta-blockers were contraindicated for heart failure — so who could predict what two decades in medicine could bring?
My first stethoscope was a gift from my parents that arrived shortly after my medical school acceptance letter. I imagined myself striding down hospital hallways with my Littman slung around my neck, flinging words like “stat” over my shoulder as I inserted chest tubes in the ICU. Of course, being a careful student of human nature, I soon realized that serious doctors never wore their stethoscopes as leashes or necklaces, but rather curled sedately in the pocket of their white coats, and I dutifully followed suit.
But over time, the stethoscope has become more of a prop than a vital organ. My golden rules of medicine are to: 1) Never order a test that will not change management, and 2) Never perform an intervention that will not help a patient feel better and/or live longer. More often than not, the stethoscope has little impact on the outcomes of my patients.
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