According to a Kashmiri proverb, “until a physician has killed one or two he is not a physician.” At first, it seems kind of harsh to consider the aforementioned statement as even remote truth, but if you think about it, most professions can abide by something similar.
Whether you’re a student in law, medicine, business, etc., the bulk of your education isn’t in the classrooms. It’s in actually applying the knowledge you’ve learned in the real world. Though I can’t speak for current physicians, I’d like to imagine that the majority of their “training” actually occurred in their residency programs where they were thrown into a hectic hospital setting having to deal with tremendous loads of patients with minimal training.
In becoming a doctor, dealing with death at your own doing seems like one of the most important things that one cannot really prepare to deal with 100%; however, at the same time, it’s something which most physicians will, unfortunately, experience at some point in their careers. Now the question is (according to the proverb), does killing someone define the physician or append to their growing knowledge of the profession?
I’m leaning more towards the latter. It’s true that based on our specialties, some medical students will be responsible for death earlier in their careers than their peers; however, this doesn’t make another individual less of a doctor. They simply have good fortune, sound judgment, and perhaps more low-risk procedures to deal with. There are countless variables that play into assessing the risks and outcome of any given treatment, so it’s not fair to say that one becomes a physician only after a tragedy.
I think personally you don’t BECOME a physician until a patient dies — no matter what measures you take as a doctor to save someone’s life. That’s when you TRULY realize your limitations as a physician and as a human being. I don’t think doctors “kill a patient” unless it’s a case of gross malpractice. If anything it’s stopping the inevitable. The other choice the patient had was do nothing – which isn’t a viable option in many cases.
For example, is it fair to say that if you’re the neurosurgeon treating a 96 yo male with subdural hematoma by craniotomy who doesn’t make it – that you killed him? Of course not!! It’s very easy as the medical student to memorize the treatment for subdural hematoma as craniotomy and have everything hunky dory in your mind as if it’s that simple. It’s MUCH harder to be actually doing the Burr hole for craniotomy and removing the clot very carefully, not to mention repairing the vessels.
I think too many times in medical school, bc things are taught so A –> B —> C that it shocks us a little when the treatments you learn don’t work no matter WHAT or HOW MUCH you do it, so you think if only I had given him a little more fluid, or compressed his chest harder, or whatever. That’s when you realize that real life is very different from that multiple choice exam that packs up a patient nice and tight like a 30 minute after school special with a happy ending (no pun intended).
Well said man! Thanks for the comment.