My adorable neurosurgeon MK has been promoted from the teaching hospital to another place as am associate consultant. Before he left, he had made such as a comment in the social circle:
... I also have enjoyed teaching the medical students because not only we could share knowledge, but also they kept reminding me how I might look like years ago...
Like him I realized I enjoyed teaching the medical students. Indeed, medical students are the best learning partner because they can act a viva voce examiner that you can prepare for examinations, when asked about clinical questions. Once you know something inside out, you can simplify your ideas and express it to a level they understand, it is very likely the examiner in real situation can pass you.
And I enjoy the teachings because most of the time, I am talking about classical, textbook-style cases. What is that, it is something that we approach the patients by taking good history, appropriate physical examinations, and then we think up a list of differential diagnoses, finally making a bit investigations and then proceed to treatment.
After the three months of the first rotation, I must say the real life is so different. What I have learnt from the great professors cannot be applied. Is it not right to take a good history and physical examination? PY, our honorable pediatrician must be very disappointed with the fact that we can bypass the criteria he set for a good physician using a urgent contrast abdomen and pelvis (sometimes plus thorax) for a abdominal pain.
Who is not disappointed?
As a result, I hesitate to tell the students about the reality. Young generations need a good imagination about the future. If I tell them, well, you no longer need history of physical examination. All you need is sophisticated imaging. They should ask me, why we still need medical education? We can simply train up a lot of radiographers and buy a lot of scanners for the patients. This is, possibly, cost-effective.
We no longer need Sherlock Holmes. The Victorian era has ended.
Because the imagination and the reality is so different, I almost had depression.
Why should I become a doctor? I told the nurses in the ward, well, I am simply a clerk, ordering a lot of investigations and did nothing good for patients at all. They laughed and thought I was joking. I was not. I lost sleep for that, wondering where will modern medicine go from the essence of clinical examinations.
What will Sherlock Holmes do if he is not going to talk to the client or go to the site himself? Well, he will indulge himself with cocaine (or nicotine patch), doing nothing.
I would have wanted to do the same, but I was brought back to the reality, and I have my mind cleared: to accept the flaw in the world. Don't you remember?
And nothing flawless, my dear fellow, is natural or genuine.
That's why 小龍女 is not a virgin. That's why 楊過 has to lose a upper limb. That's why they have to wait for so long to reunite. The true story in our life is, we have to accept the imperfection. Perfection, perhaps, only exist in the heaven. We in the end have to live with the imperfection, either it is a clinical dilemma or a daily decision. This is the life we need to have, a life that is outside the classics, outside the textbook-teaching.
So next time, I can tell the students the reality without shame. Well, flaw is, after all, something we have to understand and appreciate.
... I also have enjoyed teaching the medical students because not only we could share knowledge, but also they kept reminding me how I might look like years ago...
Like him I realized I enjoyed teaching the medical students. Indeed, medical students are the best learning partner because they can act a viva voce examiner that you can prepare for examinations, when asked about clinical questions. Once you know something inside out, you can simplify your ideas and express it to a level they understand, it is very likely the examiner in real situation can pass you.
And I enjoy the teachings because most of the time, I am talking about classical, textbook-style cases. What is that, it is something that we approach the patients by taking good history, appropriate physical examinations, and then we think up a list of differential diagnoses, finally making a bit investigations and then proceed to treatment.
After the three months of the first rotation, I must say the real life is so different. What I have learnt from the great professors cannot be applied. Is it not right to take a good history and physical examination? PY, our honorable pediatrician must be very disappointed with the fact that we can bypass the criteria he set for a good physician using a urgent contrast abdomen and pelvis (sometimes plus thorax) for a abdominal pain.
Who is not disappointed?
As a result, I hesitate to tell the students about the reality. Young generations need a good imagination about the future. If I tell them, well, you no longer need history of physical examination. All you need is sophisticated imaging. They should ask me, why we still need medical education? We can simply train up a lot of radiographers and buy a lot of scanners for the patients. This is, possibly, cost-effective.
We no longer need Sherlock Holmes. The Victorian era has ended.
Because the imagination and the reality is so different, I almost had depression.
Why should I become a doctor? I told the nurses in the ward, well, I am simply a clerk, ordering a lot of investigations and did nothing good for patients at all. They laughed and thought I was joking. I was not. I lost sleep for that, wondering where will modern medicine go from the essence of clinical examinations.
What will Sherlock Holmes do if he is not going to talk to the client or go to the site himself? Well, he will indulge himself with cocaine (or nicotine patch), doing nothing.
I would have wanted to do the same, but I was brought back to the reality, and I have my mind cleared: to accept the flaw in the world. Don't you remember?
And nothing flawless, my dear fellow, is natural or genuine.
That's why 小龍女 is not a virgin. That's why 楊過 has to lose a upper limb. That's why they have to wait for so long to reunite. The true story in our life is, we have to accept the imperfection. Perfection, perhaps, only exist in the heaven. We in the end have to live with the imperfection, either it is a clinical dilemma or a daily decision. This is the life we need to have, a life that is outside the classics, outside the textbook-teaching.
So next time, I can tell the students the reality without shame. Well, flaw is, after all, something we have to understand and appreciate.
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