Tuesday, July 29, 2008

Medical Truths #3

A doctor's greatest education is from patients.

The average doctor has put in 8-plus years of post-grad education (plus whatever college degree they received), attends hundreds of hours of continuing medical education, grand rounds, conferences, specialty societies, reads countless journals, handbooks, textbooks, and practice guidelines. All important, but nothing compared to the lessons learned from that person in the waiting room. Can a journal teach humility? Does a conference give a sense of the smell of... well, any of the myriad smells in medicine? It's the experience of the interaction that makes me the doctor I am, and hope to be.
A couple of examples:

I have learned great truths in life: Treating an 80 year old lady with dementia, she could not tell you her own name, the day of the week, or what type of building she was in. However, she did observe her 82 year old husband walking slowly with his walker, and turned and commented, "Getting old sucks."

I have learned what the doctor-patient relationship should be, but usually isn't: A first time evaluation of a 40 year old man with moderate mental retardation. I'm going through the usual questions to him and to the staff worker from the patient's group home. I'm asking about medications, symptoms, et cetera. I then ask the question "How well are you sleeping at night." To which he replied, "Pretty good. How about you?" See, I was playing the role of doctor, and he was having a conversation.

That's not in any textbook I've read.

2 comments:

Erudite Hussein Redneck said...

Nice slices of life there, Doc. Glad to see you keep up with yoir own human side. My own doc is a Stoic.


Please join me in extending best wishes to the presumptive Democratic nominee for president of the United States, Barack Hussein Obama, today, on the occasion of his 47th birthday.

Thank you.

--EHR

s said...

Good stories. Looking forward to reading more of the blog.