The theory is when we know everything and nothing works.
The practice is when everything works and nobody knows why.
Here together theory and practice : Nothing works … and nobody knows why !
Albert Einstein
My external daily in medicine, with all the difficulties it has, makes me think about the way that science is taught. As I explain in the article on the newspaper an external, I alternate between lectures at the faculty, revisions and hospital internships. During these courses, I try to apply my theoretical knowledge on real real patients; their history, their history and commodities. And for me, this is where the difficulty of medicine: to move from theory to practice!
The theory courses are a necessity
So, I learn my lessons for hours. At the end of each chapter I’m still glad I finished, I think I understood everything and remembered everything. And often a few days after I decide to do a clinical case or to answer individual questions about whether I know him: and there is the drama! I plant royally and I am aware of my shortcomings.
As I do not like to fail, I take the questions I answered incorrectly with my course and I try to understand where I did wrong. I try to make things right! Sometimes, it’s just some phrases that I understood wrong. But more often, they are whole paragraphs I Zapped!
It’s depressing to spend hours at work course and forget entire parts the next day! But hey, we’re not here to depress and then I have a certain ego: while I relearn my course, for hours …
In the hospital service: practice
I launch, enter the room, do what I have to do well trying to be systematic to forget nothing. Once completed my case, I go out and will discuss with the internal “Then you believe in it?” He asks me.
Most of the time, I do not think anything! Either I do not see anything that he may have, or I have 10,000 ideas that come to mind. But nothing clear, nothing framed like when I finished learning course…
” Thou internal imagine, in 2 and a half years only to emergencies at night!” Growls a leader. “You would have killed that poor man.” Thank you for your help, it cheers me up! – ‘
” Ask yourself and we reflect together,” advises me internally. With a little help and guidance, I think! Now it seems all stupid! And I really think that I was stupid not to have succeeded alone.
Then he asks me questions about complementary tests on the disease itself, support and possible complications. Moreover, there, blackout again: I still have no idea, nothing comes back to me! This is extremely frustrating! Then, when he gives me the answers: I remember the course, I can even say where and how it’s written on the page! But in reality, it is useless to know that…
I think it is extremely complicated to superimpose his theoretical knowledge to medical practice on real patients, even when the cases are simple and typical…
Medicine, as by heart?
Admittedly, learning of medicine requires much by heart: but as in all other sectors. For example, in math, we must learn the basics such as number of concepts (real and imaginary), operations, derivatives, integrals and spend in order to then think about when and how to use them well. In medicine, it is the same!
Why am I telling you this? Returning to my internship in the hospital.
A new patient arrives in the service, it presents the same as my previous patient. Me, so all happy to have learned the lesson, I’ll see the house and I do my top. And then he smiled: ” You have still killed him .” And yes, I had not seen hir history…
This patient indeed two problems . Now the treatment for the first illness was the killing because of his second illness. And vice versa: the treatment of 2 e disease could the killing because of her first illness. A situation which is not so rare as that!
So, how to do? Please do not apply the theoretical courses but foolishly think (+++) and beyond the scope of the theoretical bases and even official recommendations, by weighing the benefits and risks.
