“What should we do?” Mike, an intern on the team, asks as he looks toward me expectantly. It is my first week as a supervising resident, and I realize that this is the moment I have been dreading since my intern year ended. The patient in question is a medically complex gentleman admitted for transient hypothermia, and we are deciding whether a full sepsis workup is indicated.

This is an unprecedented clinical scenario for me. I lack a trusty illness script or diagnostic schema to draw upon. A quick perusal of UpToDate offers little guidance. So now I am faced with dual dilemmas; not only with what to do for this patient, but also with how to display (or obscure) this gap in my medical knowledge to Mike….

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