What really happen?

 He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all

 A Pre-Clinical Year day with only Clinical Teaching sessions.

Today, I had 2 clinical teaching sessions. A day likened that of clinical year.

Lesson/Inspiration obtained from today's teaching is Don't bother about what your mind thinking, what your patient's mind thinking, what's your colleagues' mind thinking, but contemplate on what really happen!

Human mind is flawed with lots of cognitive error. We think we're correct, but still we reach the wrong conclusion, because there's systematic error on our thinking!

Patient, as a person in this society, has different background, personal or cultural.

Different personal encounter will conceived different kind of pathology! Even the same pathology will present differently in different patient.

Our job, as a medical personal, likened a detective to find out what really happened. This is not a blind or empty minded detective, we must have sufficient basic and clinical medicine knowledge! Of course, we can't denied the uncertainties and probabilities inside medicine-pathologist knows best, sometimes, postmortem diagnosis can be bizzarely different from the treated alleged provisional diagnosis.

What basic and clinical knowledge that we need to have?

Basic medical knowledge, such as anatomy, physiology, biochemistry, pharmacology, pathology, microbiology and immunology

Clinical medicine knowledge, an extension from basic medical knowledge,for me mainly consist of a clear, rational mind that can see what really happen, deduce various possible,relevant causes of disease with critical thinking, ample of bed side manners and well-practiced physical examination skills.

There's a lot of new disciplines emerges each day, for me that's the outward florishes of basic medical knowledge. Therefore our main job in medical school is to grab a firm stand on basic medical knowledge, acquire a clear, rational, critical thinking mind and last but the most important one, be courteous to patient with satisfactory attitude,ample of empathy, tactical communication, integrity and altruism.

For me this last one aspect, differentiate a doctor from a non-doctor. Any smart guys can perform the previous 2 tasks well, if they devoted some of their time on that. However, only doctor (I mean persons who are really passionate and meant to be a good doctor) can bear the pain and joy of taking up the latter skills.It will be rewarding.

Personality goodness is normally distributed, so do among doctors, who aren't flawless human, but remember to give patient, their family, our colleagues, our co-worker, our teachers and our family their due. Personality is what we are born with and can be molded.

The theme back to What Really Happens?

At times, I felt the hard time to come out with a clerking question or a case report - Because I simply don't know much about what really happen. I have only text book knowledge, or even worse, I don't have them. The tips here is to see, look! this is what happen to our dear patient, think and integrate our textbook knowledge, our common sense, our non-academic knowledge of patient background and critical thinking together. Then we'll know what really happen. Then we can come out with a rational report and plan of management.

Next time, note to self, ask What Really Happens?

Journey to be a doctor is hard. Much efforts are paid off, passion and interest are the fuel that keep us moving on. Medical education on university undergraduate level is meant for us to acquire the learning skills so that we can continue our learning even without an institution- well that's useful for a medicine practitioner.

What we get from medical school is really meant for Treat Disease, Prevent (unnecessary)Death!

However, much we can empower and top-up for our own learning sphere, so that we're well rounded, so that we're really practicing medicine that approaches sick people-We will not become Dr. who expertised in treating the leg/heart/liver/guts....so on...

Look, what really happens! It is a sick person drawn from his/her normal daily living in the society and go to your institution to seek help.

Another case of diabetic foot? Think twice before you said that next time. That poor guy/girl have their own story to tell, swallow them, but don't believe them anyway. Don't believe what your mind's thinking anyway, don't believe what's your colleagues' thinking anyway. Look, and feel and project, what really happens?