30 Days to Better doctoring
I recently discovered Dr. Eric Levi's list for 30 days to better doctoring. He's an ENT/Head and Neck surgeon who created this list as a pursuit of improving his practice. Two days stood out to me specifically as an intern entering my second month of residency.
Day 24: Slow Down
You are always running, probably. I know I used to. I used to always run between theatre, emergency, the ward, clinic, preoperative holding bay, recovery, etc. I need to run so I can pack more things into my day and spread myself thinly over many things. In the midst of running, I often realise that I am less effective and less helpful to others. I project this air of busy-ness and keep others at a distance so they won't bother me. But I'm learning now to slow down and purposely hold my thoughts longer. I'm learning to slow down during rounds so I can spend a bit more time with patients, and allow students and nurses to stop me and ask me questions. I slow down enough to make me interruptible and approachable. I slow down enough to allow my mind to think clearly. I sit on the patient's bed. I sit on the nurses desk. I slow my footsteps. Interestingly, I still get the same amount of stuff done (or not done) during the day whether I am at 110mph or just on slower speed. I am realising that slowing down is good for me, my colleagues and my patients. Try that.
It's hard to believe the same things would be completed when you're not on 110mph mode. It seems like you have to be in that mode in order to complete all of the things. And maybe it's slightly different as a seasoned attending than as a new intern, juggling so many unknowns. But it's also more of a mentality and approach -- even if I am running around like a crazy person, try to take moments during the day to pause, to sit down, and to create a more sustainable approach that is less conducive to burn out.
Day 29: Teach, Teach, Teach
'Doctor' comes from the Latin word 'docere', meaning 'teacher'. 'Surgery' comes from the Latin 'chirurgia', or Greek 'kheirourgia', meaning 'working with hands'. I believe as a surgeon I am called to be a teacher who works with my hands. The primary duty of a doctor/surgeon is to teach. To teach patients how to live better. To teach students the causes and treatments of diseases. To teach nurses how to care for patients. To teach families how to support a patient in need. To teach, teach and teach. You've heard it said before, "Give a man a fish, and you'll feed him for a day. Teach a man to fish, and you'll feed him for a life time." And that is true. Caring for one person for a day limits my impact. Teaching how to care for a person will teach the patient, their families, their carers, their nurses, my students, colleagues, and many others the art and science of better living. Teaching is foundational to the legacy of health I will leave with my patients and the doctors after me. Long after I've laid down the scalpel, it is my legacy of education that will continue to bear fruits of healthy outcomes. By teaching, I do not mean a transfer of information. No, the photocopier does that. Teaching, to me, is primarily measured by a change of action or behaviour resulting from an educated mind. A life change, like stopping smoking, caring for ear health, vocal hygiene, etc, are the outcomes of my teaching as a doctor. Antibiotics and surgery are just some of my tools. And when I see a non-ENT doctor being good at managing BPPV, otitis externa, chronic rhinosinusitis, salivary stone, etc. then only have I done my duty as an ENT surgeon. Teaching is not focused on the teacher, but the student. Teaching a patient to stop smoking requires a different technique to teaching a medical student the biochemical carcinogenic effects of smoking. Every moment is a teachable moment. Not a lecture session, but a teachable moment. Be proactive in teaching today. Fulfill your ancient Latin calling as a doctor/teacher.
A lot of people in medicine are as passionate about teaching as they are about learning, and that is what makes this environment so incredible. One of my favorite quotes by Maya Angelou is "do the best you can until you know better, then when you know better, do better." We are all doing the best we can with what we have (for the most part). I love the idea of sharing knowledge, having discussions, and being better because of it. Part of this (and a big part of residency/becoming and being a doctor) is understanding you are imperfect and that that is okay...but also remembering that your patients and your patients' families look to you as if you know everything.
Photo by @vrslyapp