Shifting Dullness

Shifting Dullness is a classic sign for ascites found on physical exam: if a patient has intraperitoneal fluid, the border between tympanic and dull resonance with percussion will shift as the patient’s position shifts. Shifting Dullness also happens to be a cleverly named former Duke medical student publication. Started in 1968 as a weekly announcements bulletin for the School of Medicine, it evolved over three decades to include creative writing, artwork, humor, editorials and opinion pieces contributed by medical students and other members of the Duke Med community.

Sadly, publication of Shifting Dullness ended in the late 1990s for unknown reasons, leaving behind only memories and a treasure trove of paper archives in the student lounge on the 7^th floor of the Davison Building.  Rumor has it that these archives were re-discovered by the Davison Council while cleaning out the lounge in 2011 and turned over to the Duke Medical Center Library for safekeeping.

I first heard about Shifting Dullness when I started at Duke in 2011. Keen to keep the non-science part of my soul alive during medical school, I asked around about a student literature publication and eventually caught wind of the long-lost Shifting Dullness. A few of my classmates and I met with the Duke Medical Center Archives to discuss digitizing the collection in hopes of a 21^st century re-boot. We sifted through the collection, discovering a fascinating time capsule of life of the Duke Medical Student in the 70s, 80s, and 90s. I was surprised to find that by the late 1980s, the publication had become a rich forum for the School of Medicine. Amidst routine school and club announcements were debates about physician-assisted suicide, commentary on the importance of computers in future medicine, poetry, cartoons, and plenty of comedy and satire.

As the issue we’ve included here from March 1991 shows, not too much has changed in the past quarter century at Duke Med. This issue and others from the era are full of opinions and satire regarding the ever-changing curriculum, worries and opinions about the boards and the match, and content on the numerous volunteer activities and unique social life of medical students. I find myself laughing (out loud!) at all the comedy and satirical content, because it’s still so relevant to my experience as a Duke Med student today.

What stands out to me as different is that these perspectives and issues are captured in a centralized and regular publication, in an uncensored and unadulterated voice.  Where is that voice now? I’d argue it has become lost in the fragmented yet unrelenting barrage of emails we all receive daily. Perhaps we’re now too overexposed to media and overwhelmed by the ever-increasing demands placed on us as medical students to be able to sustain a forum like Shifting Dullness anymore. It’s true that AMA’s VOICES now provides a creative and intellectual outlet for Duke Medical students, but it is biannual and submissions are not easy to come by. Where is a centralized, safe place for us to communicate: our complaints, ideas, stories and fantastic jokes, even those that may be controversial? Is such a place even viable today?

I urge you to check out the Shifting Dullness archives housed in the Medical Library’s digital repository, particularly those published after 1987.  They’re fun, thought provoking, and sometimes shocking. If you’re inspired, have ideas or answers to the questions I’ve posed above, or are interested in a 21^st century Shifting Dullness re-boot in conjunction with AMA VOICES, please get in touch with me or one of the AMA editors.