Med-Mania

From The Harvard Medical Commencement Address 2005

By

Atul Gawande, MD, MPH (b. 1965)

A doctor is a white-coated cog in the medical machine. To avoid getting whirled and lost in this machine, the doctor can:

Listen to an unscripted question

Ask patients beyond the details of diagnosis. About their favorite pastime, freaky character or fumbles in life. Connect with them on human terms. Don’t conclude but connect.

"Where did you grow up?" Or "What made you move to Boston?" Or, "Did you watch last night's Red Sox game?" Not a deep or important question, just one that lets you make a human connection.

A doctor’s job is not just to look at the lump but look into the heart and humanly connect with it.

Then, “the machine will gradually look less like a machine.”

Don’t whine.

Complaining can crush your potential and help you develop a crush about trivial things. Instead of grumbling, stumble into a idea or a poem.

“Resist it. It's boring, and it will get you down. I'm not saying you have to be all Julie-Andrews-Mary-Poppins about everything. Just be prepared with something else to talk about: An interesting patient you saw, an idea you read about, even the weather if that's all you've got.

Then see if you can keep the conversation going.”

Count Something

A doctor – whatever may be his specialization – is a scientist too who must count how many patients he is seeing, how many patients are left with sponges and scissors. This counting can cut through such errors and may avoid future leftovers in the patient. Let the patient leave you with love not come back with a lesion-like leftover.

“If you count something interesting to you, I tell you: you will find something interesting.”

Write Something

This is critical for Atul. Because, “what you write does not need to achieve perfection. It only needs to add some small observation about our world.”

Be ready to Change

This is interesting as most doctors are stubborn that they react hysterically to anything against their diagnosis. They are quite resistant to Change.

A drug Vioxx, a pain reliever which was voluntarily withdrawn from the market after it was found that though it didn’t affect the digestive tract, it could cause heart attacks. Even the voracious Viagra can lead to partial vision.

Atul analyses the state of medicine with amazing clarity…

“As successful as medicine is, it remains replete with uncertainties and failure. This is what makes it human, at times painful, and also so worthwhile.”

So, get the conversation going and connect with humaneness and compassion.

*

"I am a member of a fragile species, still new to the earth, the youngest creatures of any scale, here only a few moments as evolutionary time is measured, a juvenile species, a child of a species. We are only tentatively set in place, error-prone, at risk of fumbling, in real danger at the moment of leaving behind only a thin layer of our fossils . . ."

Lewis Thomas MD (1913-1993)

Physician–Writer