MED SCHOOL MAXIMS ....for all of us

    Have you ever been searching for a particular 'something' only to have another item turn up and then mused to yourself 'Well, there it is; I had wondered where I placed it.' ?  A few days ago, I was attempting to locate something that I had deemed 'essential'...now I donot remember what it was; but I found the notes for a presentation that I made a couple of years ago.  Our counseling center is part of a major teaching hospital and I was asked to speak to the rising Fourth year class of Med Students.  The topic was 'Taking Care of Yourself as a Medical Student'.

     These Maxims or Aphorisms seem (with some slight modification of detail) to be applicable to many professions and occupations . . .and maybe to life in general.  At any rate, an abridgment of the notes:

     I have never been a Medical Student. I have been a Graduate Student in the MA program at Wake Forest University and the PhD program at UNC-Chapel Hill.

   I  did read a book once about med school life . . .which I highly recommend to you: Ferrol Sams, When All the World Was Young.
It  is volume three of his only slightly fictionalized trilogy about growing up in   rural Georgia pre-WWII.  The last volume describes his time as a med student at Emory University at the onset of the war and his service in the military.

   When I was asked to attend this orientation and to speak on the above topic, I decided on a slightly different slant.  I wanted to do a Letterman-esque "Ten things I Wish I had Known when a Fourth Year Medical Student".  So, I asked my younger brother who has been an Orthopedic Surgeon for 40 + years for his input on "Self Care".

     Now, my brother tends a tad towards 'earthy' and 'plain spoken' (which isn't the same things as 'vulgar'. So, be warned ...)  He replied: "Beats me-don't have a clue what you're referring to : self care.  Get up in the morning, brush your teeth, take a crap, shave and shower, no? Really, though I don't know what the term means to you.  Obviously more than it conveys to me. So, if I have any chance to be of any help...[being] more practical and less reflective than my two brothers, I'd need to be filled in a  bit more."

     So, I gave it to him in a different frame:  "Ten Things I Now Know That I Wish I Had Known Then About Being a Physician."

     I then read to the assembled group what my brother wrote in response to the request. Those comments (which I'll give momentarily along with some of my own commentary) prompted me to reflect: "I love book titles. Some are so descriptive that reading the book is almost a redundancy.  Here's one that my brother's email brought to mind:  If You Don't Know Where You're Going, You May Wind Up Somewhere Else.

     Perhaps there are limits to planning and goal setting, and as someone trained as an academic historian as well as  having been privy to hearing many stories in my clinical office, I know for certain that there often are a variety of possible outcomes to situations and that the way things turn out does not always mean that such was the only option.

     Consquently, I want to suggest that a part of   your 'Self Care' as a 4th year Med Student might lie within some of my brother's  reflections.  Some speak eloquently for themselves; for others, I have added some of my own comments. First, his reflections in " ".

1. "You shouldn't  ride in 'on your white horse' and think you can solve all the problems of the world because you're smarter than everyone else-you're not."
    His medical pedigree for that comment is pretty good. Undergrad and Med School at UNC-CH; Intern and  Resident at Yale; OJT at Saigon General ca. 1970.

2.  Perhaps  experience at the latter informed his second comment:
"You can't make  chicken salad out of  chicken [poop]---some things you just can't fix."

3. "All  people deserve the right to be  listened to; don't see patients with one hand on the door as if you are heading out."
     Malcolm Gladwell in The Tipping Point indicated that the doctors who are least likely to be sued are those who treat the patient with kindness, care, attention and time.  It's important to make the connection and avoid treating people like a "sack of symptoms".

4.  "Think--would you want to have the treatment you are suggesting for yourself or for your family."

5.  "Take time to enjoy your family and take time to do things with them---kids grow up in a flash and are gone."

6.  This next one brought a huge laugh from the audience: "Be collegial with your compatriots--there'll be enough money to go around, and it's not the cash that brings the best feeling of reward--it really is about helping other people."

7.  "Don't let the feeling of 'is that all there is?' get you down---and there probably will be those days."

8. "Take time each day to enjoy the world around you if you can; it relaxes you."

9.  "Have something other than medicine that you care about, because the likelihood is that at sometime, you'll not be able to continue to practice and if you don't have any other interest, you'll be a grumpy old fart."

10.  And one that I would add: "To ask for help when you cannot solve a situation yourself is not a sign of weakness.  It's a sign of intelligence."

11. Oh, yea, there was one other 'pearl' from my brother: "One of my med school profs said,'hindsight's better than foresight by a  damned sight!'  Apropos of nothing I guess."

You never know where you might hear a 'life lesson'.  This was in a "Hagar the Terrible" cartoon.  His young son asks: Dad, if you were my age, what would you do with your life?"  Hagar: "I'd always listen to my parents, develop good work habits, and I'd study hard to get a quality education that would help me in years to come."
   Then, in the second panel: "But I'd make VERY, VERY sure I had a lot of FUN along the way."

      Satchel