The first week of Paediatrics was packed with lectures and presentations. Chapters and endless pages of literature topic by topic all squeezed into one or two hours at a time. I think it's rather humorous that Clinicians emphasise oh so very much the importance of evidence-based practice and yet, we are still using traditional didactic teaching methods with some additional fancy gadgets compared to a few decades ago... all of which arguably have little evidence in the context of educational efficacy. But hey, that's why we have clinical attachments for the next three weeks - where each week we'll all be in different departments. Just when we get the hang of where to show up at what time, the names of all the staff members and our second chat with the consultant that involved being asked questions we couldn't answer, we will be off to experience the disorientation again in another department. Charming!
But I don't really mind. I just enjoy predicting how miserable I'll be in six weeks from now. So on our first day back, I was curious about how people might have changed after their elective term. How did their experiences affect them? Are they affected at all? I pondered all the way to the wrong train station, then all the way back to another train station and then back on the wrong train again. I showed up at 1045 when we started at 0830. I don't think I've ever been so late in my university years; at least not by mistake.
Morning tea time! Unheard of in my elective hospital and something I welcomed before our next couple of lectures on a Tuesday morning. I was talking to one of my colleagues, who is hell-bent on becoming a surgeon and already in the process of deciding which pathway he should take to become the sub-specialist he would like to become. I admire people who have already understood and appreciated their years ahead, but being so specific? I can't help but feel their insight must be restricted to what they've seen in the context they saw it.
I listened intently to his stories from New York, where he saw dozens of trauma cases, scrubbed into case after case learning techniques and getting down to the fundamental principle of Surgery: to save life in dire need. He was sure he wanted to become a Trauma Surgeon and from his list of credentials plus the scholarship he received to see what he did, I see him on the successful path to doing exactly what he wants to.
He passionately explained "procedures unknown to us in Australia" to save the lives of people who were in horrific accidents, victims of domestic violence and gang warfare. He described the unique procedures to me and yes I agree, they were quite radical and probably not performed in Australia routinely. And only a handful of people could perform them.
But throughout this encounter, he never explained anything about the patients except for their presentation to hospital. Typical surgeon I hear you say, but that's not true. Surgeons must still take an interest in their patients beyond their anatomical planes and site of haemorrhage. Patients are not just a list of potential complications, risk factors and mechanical defects... and to hear my colleague explain these patients and their management depressed me because I'm sure he didn't know a single one of their names.
So some of us are already falling into the trap of adapting personality and behavioural traits that will not make us good doctors. And this fine medical student, a distant colleague of mine, is well on the way of becoming what he always dreamed of... but I'm sure somewhere in those dreams he didn't consider the guilt of not providing reassurance, or empathy.
Perhaps the whole point of being a Trauma Surgeon is not to interact with people or obtain consent; the law has provided that for you - just ensure the patient is resuscitated so that they can form opinions again. Oh and if their opinions were not what was expected (i.e. instead of "thank you so much, God bless you, I'm alive" one is told "you couldn't spare two minutes to explain what you did; you told me to come back in two weeks to be seen again but I don't know why") - then maybe, just maybe, the principles and philosophies you (medical student) based your career on need revision.
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| The problem "is" choice. |
