We can learn something from every patient without becoming cynical

Editor - As a third year student in the new problem based learning course at Liverpool, I have to see around 250 core cases before the end of the fourth year. I have been informed that many students in the year above have left their patient clerking late and so are currently running around clerking furiously (making up a few in the process, no doubt). All students have been advised by faculty to see as many as possible now.

Imagine my surprise when I saw a nine year old boy with 10 conditions! The total was 11 if you include his mother, who had a post partum haemorrhage. My partner and I were amazed and proudly entered the common room to boast about our "super patient." We basked in the glory. Then I read the article by Rob Morris¹ and it made me think. Am I becoming hardened already only to reach the status of Prince of Darkness not by the time I'm a consultant but upon qualification?

I feel there are two important points. First, I believe that the joy associated with finding core cases (or interesting signs) is not a result of becoming a hardened student but rather represents the completion of a task and the subsequent releasing of pressure. Once this is done, one can relax and start the real learning since the "official bit" is done. Second, does it actually affect patient care? Do I really think less of an MI patient when I clerk him/her simply because he/she is my 10th one? I can honestly say no; each patient is different and one can learn something from each one even if it is simply communication skills.

It is for these reasons I do not feel guilty about my boast and truly believe that my joy associated with the little child's conditions was not because I saw him merely as 10 ticks.

Naseer Ahmad, third year medical student, University of Liverpool, Liverpool
Email: naseer.ahmad@barclaysonet


studentBMJ 2000;08:217-258 July ISSN 0966-6494

1. Morris R. Student soapbox: Descent into cynicism. studentBMJ 2000;8:203.