“I am always doing that which I cannot do, in order that I may learn how to do it.”
– Pablo Picasso
I never took an art history class in college, but to my knowledge Picasso never went to medical school. Despite his never stepping foot into an anatomy lecture, he managed to capture the essence of medical training in this single sentence!
When I first read this quote, my mind instantly went back to our early weeks in our Medicine and Society module, when we donned our white coats and gave our best door knock and “AIDET” to the first standardized patients. It was certainly a moment of “that which I cannot do,” and there was a lot of “Whose Line Is It Anyway?” type improvisation going on. I cringe when I look back at my first video recorded history and physical. In hindsight, I can say that my classmates and I all had a severe case of “I don’t know what to do with my hands” syndrome. We positioned the standardized patients in all sorts of awkward ways, and then their drapes would fall off. Stethoscopes were dropped. Tuning forks were hit far too hard on the counter top (OK…I’ll take the credit for that one). Abdominal palpation couldn’t be distinguished from pizza dough kneading. It definitely was a sight to be seen! During the whole process, I could only imagine what our attending physicians were thinking.
To my surprise, it turns out that they were all thinking on the same wavelength as Picasso. There’s a first time for everything, and once upon a time there was a first time for them. Of course our poor practices were quickly corrected, but in a way that allowed for constant improvement and practice. We practiced on standardized patients and on each other until a history became a conversation instead of a verbal checklist, and a physical exam flowed logically instead of making the patient dizzy with the constant, “Sir, could you sit up? Actually, stand up. Ok, now you can turn over. Wait, no, now I forgot something.” As could be expected, by our final OSCE (objective structured clinical exam), everyone in our class could take a history in their sleep. Physical exams were natural, and hands were much more gentle and skilled.
Medical training is full of awkward firsts, and I know that last year was just the tip of the iceberg. To that end, I am eternally thankful for the physicians that we work with on a weekly basis who bear with us through our fumbling and failed attempts. Not only does our curriculum make room each week for practicing skills in the simulation center and with standardized patients, but our mentoring physicians are there giving us tips and tricks every step of the way.
By no means do I have a history and physical down to a science, but to look back at how far I’ve come in one short year is really encouraging! Our progress wouldn’t be possible without a school and physician mentors that guide us in “doing things that we cannot do” early on in our medical training.
With one year behind us and three to go, Picasso’s words will serve as a constant reminder that although there will always be a long list of things that we can’t do, we couldn’t be in a better environment to learn how to do it.
Copyright 2014 USC School of Medicine Greenville