The Power of “I Don’t Know”

I hope to be a doctor. This type of doctor – one who prioritizes her patients’ needs and gives every patient autonomy over their health: http://www.washingtonpost.com/national/health-science/how-i-discovered-an-important-question-a-doctor-should-ask-a-patient/2015/03/09/ca350634-bb9c-11e4-bdfa-b8e8f594e6ee_story.html

But there is something uncomfortable I’ve noticed about the general attitude towards premed classes. Many, myself included, went through our elementary level classes focused on trying to cram as much information into our brains as possible without regard for the long-term goals. I didn’t appreciate the idea of “applied learning” until a couple years later. And if called upon in class to answer a question to which we didn’t know the answer, we would spew random facts even though we knew they were incorrect, or try to rationalize an answer based on knowledge we knew we really hadn’t studied enough.

Now, at my hospital job, the precision of the decisions that physicians make must be perfect. The job is both high risk and high reward, but a miscalculation can cost a patient their life, and time is of the essence. One must never assume in a medical context. Having worked there long enough to see patients in extremely critical conditions, I’ve observed how carefully the physicians work in order to deliver comprehensive care even when they need to work quickly.

No stone is left overturned. If a doctor has a critical patient that they need to treat right away, but they are unsure about something, they will still double check with another physician before performing the procedure. It is key to develop this habit of learning not to act on egotistical whims and realizing that it is not a bad thing to ask for help or advice, especially when your mistakes could cause a lot more trouble in the near future. I learned last week that in 2003, the hours that medical residents are allowed to work in a week were changed to 80-hour workweeks. Beforehand, residents had been working 36+ hour shifts (I even heard a story of a 60 hour shift) and 100+ hour workweeks, which had supposedly led to a patient’s death in one case (the case which was primarily responsible for the change). There is a certain level of masochism that goes into working these lengthy shifts. Even I feel it sometimes when working an overnight shift, or working long shifts many days in a row. I wonder How long could I keep going like this until I collapse? I’m eager to see how much endurance my body and mind have. When I heard the story about the 2 residents whose patient had died, though, I wondered what the mentality of those residents was like. Did they need help or relief and were too afraid to ask for it? Or were they just fulfilling expectations without considering the fact that they might be too tired to make rational decisions?

Vedanta and yoga philosophy emphasize this same type of careful learning that I described above – this yearning as a spiritual seeker rather than gloating over knowledge already accumulated or becoming complacent. The learning one has already acquired becomes a reserve of practicality, not a heap of laurels to sit upon.

I don’t deny that a basic level of strong scientific knowledge is absolutely essential to becoming a competent physician. But once that baseline level of knowledge is obtained, having the humility and courage to say, “I don’t know exactly how to solve this” when they first encounter a complicated medical case gives the physician a power of honesty and clarity of thought. And especially in the medical field, this allows for more creative thinking and collaboration – and lets the physician gain more insight into what the patient really wants.

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