Tuesday, 23 September 2014

As long as you can manage to stay awake

Posted by Jean Adams

I was sitting in a meeting the other week when someone started talking about ‘Jamie and Tom’,* in a slightly context-free way, like I would definitely know who they were. It was at this point that I realised I only knew who about 50% of the people around the table were and that we’d got to agenda point 3 without any introductions.

One of the most common activities I did as a medical student was sitting at the back of a clinic. The doctor would do their job, seeing each patient on that morning or afternoon’s list; my job was to learn by observing. It’s not always easy to keep concentrating on this sort of ‘just watching’ learning. Hospitals tend to be warm places and the student isn't actively engaged in the consultation. To help me stay awake, I made a rule that I would try to ask the doctor at least one question after every patient. Sometimes I asked questions I knew the answer to, just to prove to everyone that I was still awake.

"Thomas Eakins, The Agnew Clinic 1889" by Mark Skrobola - note how engaged medical students were in the 19th century
I’m not sure I can remember anything I was actively taught during a clinic. What I really remember is learning what sort of doctor I did, and didn’t, want to be. I wanted to be the doctor who spent a whole afternoon consulting with people with the dreadfully debilitating, but hard to treat, chronic pain syndrome without once loosing their patience. I never wanted to be the doctor who walked out of the door when their patient started weeping, leaving the nurse to 'deal with it'.

As the meeting went on I eventually worked out that Jamie was female, and was a little bit upset with myself for auto-assuming she wasn’t, but a little bit pleased with myself for taking a tiny step towards nailing down her identity. Then someone started talking about GVS-super-TRP**. I looked at the meeting papers for a clue as to what this might be, lost the thread of the discussion, and my brain slipped away to something much easier.

In order to stay awake, I wrote a list of the things that had gone wrong in the meeting. Right there, on my agenda: no introductions, no explanation of GVS-super-TRP. Looking back, I hope that I wrote in enough of a scrawl that the person next to me wasn’t able to witness my impudence. It’s not like I'm some ninja-meeting super-hero. Note: I didn't interrupt to clarify what GVS-super-TRP was, or ask who Jamie and Tom were. Participants not asking for clarification when required was on my list.

The bad meeting experience reminded me of my medical student days and how much you can learn by just watching. How much you can learn about how to do things well and how to do things badly.

I was attracted to medicine partly because I liked the idea that it would take a long time to get any good at it – learning and working at doing it well would keep me busy for a while. Similarly, I like that research is not something I will be done learning soon. You don’t get a piece of paper one day saying “you are now qualified as a researcher: go forth and research”. There is always more to learn and always more opportunities for learning – even from meetings that don't go so well. As long as you can stay awake.

*Obviously not their real names, but definitely one name was one that could be either male or female.

**Whatever it was, I don’t want to compromise the true acronym’s confidentiality, so also not it’s real name.

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