just some things on my mind today

(These are the experiences, opinions and views of the author only and may not reflect those of the majority.)

Just yesterday, I was handed a book on the history of surgical pathology, and in it were some autobiographical notes by one of the prominent founders of the field. And as I was reading about his experiences in medical school and his training beyond, I grew excited. Medicine back then was fun. We are, by the way, in the first half of the twentieth century. I began to compare my education with his and must admit that I am bitterly disappointed. I began to think, what is it that I really learned in medical school? I learned how to read a book and ace a test. I learned how to get up really early and function, albeit maybe not well, in a sleep-deprived state. I learned how to be ignored and treated like I was invisible and be okay with that. I learned how to write a detailed note on a patient, often copied from the previous day with minor changes in vital signs, etc. I learned how to follow directions, obediantly and submissively. I learned how to go through the motions of doing a physical examination on a patient. From an outside observer (the person grading me), it appeared that I knew what I was doing, but I was never taught (with few exceptions) the significance of going through these motions. I learned how to order tests, lots of them and was taught that tests will give you answers. I learned how to wade through massive charts to find information. I learned how to dress, act and talk like a professional, how to wear a short white coat stuffed with books and penlights and papers on which I had scribbled notes, heavy on my shoulders, weighing down my spirit. I learned how to please people, what I had to do to get a good grade and how to make patients happy (usually). I learned how to not get sued. I learned how to say, "Hi, my name is Dr. ____," which may not sound that difficult, but is. I learned a lot. So what am I complaining about? I didn't learn the most important thing (at least to me), that which the prominent early twentieth century physician spoke of in his training, and that is the art of medicine, how to truly examine a patient and solve a problem and think and ask questions. Yes, I learned medicine from books, but not from my patients, with the exception of my short experience in Africa, and yes, I am bitter. I think we can do better. I think we should do better. My experiences in clinical medicine are a major reason why I have chosen to leave it. In pathology, there may not be living, breathing patients, but at least I can still do real medicine. Had I gone to medical school 100 years ago things may have been different, but today this is the best I can do.