Curiosity in Medicine

On my medicine rotation one of the morning reports was about an article from the American College of Physicians in the "On being a doctor" section. It was simply called "Curiosity" and proceeded to describe how the trait is both systematically beat out of medical students and one of the most important traits in a physician. The author included many salient examples, of which I distinctly remember two. In one scenario the medical student was reporting a patient's past medical history to the attending and stated, "Stung by scorpion in the scrotum." The attending stopped the student and asked how that could possibly have happened. The medical student looked confused, probably as to how he/she had failed to wonder that as well, and admitted to not knowing. In the second example a medical student stated that the patient they were examining had a history of a BKA or below the knee amputation. The attending stopped the student and pointed out that the patient had both his legs. It turned out the patient had a history of DKA (diabetic ketoacidosis) and it had been mistranscribed for years in his medical record.

To me these examples are classic examples of the differences in how attendings and medical students think. Medical students, myself included, tend to miss the forest for the trees. We focus on gathering every last piece of data from every possible source and sometimes fail to put it together. We finish scribbling down vital signs and present a minute later without synthesizing what all the data is trying to tell us.

Before this article, I used to look like a squirrel about to get run over when I was presenting to attendings. I never knew where they were going and they never knew where I was going either. After this article though I started thinking about my patients in practical terms. After that attendings began to seem much more predictable. Their questions aren't haphazard to make me feel terrible, they're questions to find out how to best take care of their patients.

For example, if I tell the attending that their patient had a fever, they're going to ask me if my patient had a folley catheter in, was sort of breath, and if they have an IV in. Those are logical questions, but I would miss steps like that. Now, because of this article, I'm able to take a second and ask what I would want to know as an attending and it's made me provide better care of my patients.