Seperating medicine from the rest of your life
Editor - Mr Singh hits on an important point in his Soundings column.1 However, he has failed to notice that spotting medical conditions has its roots not only in our personality and family background but also in the way we are trained.
As clinical students, we are indoctrinated with the need to notice things. Being observant is vital, be it the position of a leg following a fall, thyroid eyes, Marfan's syndrome, or even plain obesity.
However, the training of our observational skills can often get out of hand. Doctors sometimes use it to enforce their position of power and authority over the patient. I was once asked to "just have a look at the lady in cubicle 6; don't talk to her, just look and then tell me what you think". There cannot be a greater example of objectification of patients than this. The doctor might as well have added "if you engage with this person at a human level, you are not playing by the rules, and may not learn a clinical fact from this situation.
On a more humiliating level, a bored consultant on a cardiology ward round suddenly asked me what I had thought of a young child in an oversized pushchair who we had passed in the corridor. I responded, as I often do, with dumbstruck silence. Apparently the correct answer was "well it hasn't got Down's but it was certainly funny looking." He went on to tell me that the correct term was dysmorphic and that it was important to spot.
It may be important to spot this in the consulting room or the ward, but surely it is also important that we learn to separate medicine from the rest of our lives. That means not objectifying people we see in the street as medical objects. It's difficult, because the way we act is dictated by what we know, and what we know after 5 years at medical school is different from what we knew before. The perception we have of the world around us is an important subject that deserves more than a flippant brush over by one of the worst columnists the studentBMJ has ever had.
Helen Morant, final year medical student, Nottingham
studentBMJ 2000;08:175-216 June ISSN 0966-6494
- Singh D. Assume the physician. studentBMJ 2000;8:168 (May).
