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Monday, February 25, 2008

Never can know enough

One sentence from a recent typically well written and insightful contribution by Intueri particularly resonated with me.

We [physicians] find ourselves pulled into the belief that we are squandering our skills and potential if we are not tending to our patients (through direct patient care, reading, studying, etc.) as much as we can.

I've written before ( now three years ago) about the transformation of a layperson into a physician. Much about that transformation is captured in that sentence.

That sentence describes how I felt beginning sometime in medical school and ending gradually sometime after I retired. Always the nagging fears of not knowing enough and not being alert enough and not working hard enough were there.Now since nothing I read will be translated into any real action for or to a patient( except myself and spouse) although I still read and think about medical matters a lot it as Osler said "He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.

Now when I read about the latest study on ventilating patient with ARDS it is with interest but it is not with the same limbic valence as reading about something that you know "will be on the test" or that you may will really need that information as you go to sea. As much as anything that is a major part of the "transformation" back. Without that motivation to try and know enough to do the right thing for your patient and to know that you will not be regularly asked what to do by your patients really does make the transformation nearly complete. Fully complete may entail not letting that bother you so much.

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