Comedy (or is it?)

[pellicle]

I often read here of absolutely miserable bedside manner of medical professionals (and have experienced quite a bit myself)

I read this morning (don't ask) this amusing statement

Medicine is both an art and a science. Both are interdependent and inseparable, just like two sides of a coin. The importance of the art of medicine is because we have to deal with a human being, his or her body, mind and soul.​

LOL

I'd say its an art (like being a potter) that relies on science (to provide tools like imaging and antisepsis) but that the practitioners are indeed Artists who don't like being questioned or scrutinised. Just the tip of an iceberg

https://www.theguardian.com/society...ts-death-rates-bruce-keogh-jeremy-hunt-health

 

[Wiles Darkwinter]

Pellicle, I've noticed a very anti-clinician vibe in many of your posts. You make some good points about the state ego of some medical professionals, and I do agree with most of these comments. However, in the interest of conversation, and given this is an off-topic post, do you see any good in clinicians these days, and what defines a good one in your eyes?

I for one have encountered some bad ones (Refer to my original post about my surgical journey) however mostly I've met highly competent, scientifically literate modern clinicians who enjoy what they do. I think the ego can help the role of a surgeon. I've just read Henry Marsh's Do No Harm - British Neurosurgeon, who chronicles his career and lays out the good, bad and ugly - including cases where his mistakes lead to his patients dying on the table under his hands. It's very revealing.

I think it is indeed an art, however the art gallery that is the human body has rules - some which we know, some we are still learning, and some which are perhaps beyond reach? (consciousness, free will, love). Henry Marsh dramatically says a surgeon must have the heart of a lion and the hands of a woman.

 

[pellicle]

Good morning (sitting down to first coffee this Sunday morning on the other side of the world)

Pellicle, I've noticed a very anti-clinician vibe in many of your posts.

thats interesting to hear and perhaps a bit of a broad brush to paint me with; as clinician does include anyone in medicine in "Clinical Practice" (which will be everyone from a basic nurse, through to a cardio-thoracic surgeon). I don't recall ever saying anything bad about my Cardio nor my Surgeon nor any of my clinicians (certainly nothing like this thread). INR Clinics on the other hand are a "machine" not a person and allow people to do things which those people can say "it wasn't my decision" (a whole psychology sub speciality right there).

Since we're having a conversation I guess that you may have had the opportunity to serve with some Australians. If you have then you no doubt observed we have different humour and culture. Usually more black than Americans or Canadians. I'm perhaps blacker in humour than most of my fellows and sit closer on the scale to Estonians or Finns (but not Lithuanians who are darker still). A classic Finnish gag about Estonia

So while it may be difficult without experience to judge me on a scale that you're unfamiliar with, what I'm saying is I don't think I've been hard on Clinicians (while that is only my view of myself not how others see me {over which I have no control}).

You make some good points about the state ego of some medical professionals, and I do agree with most of these comments. However, in the interest of conversation, and given this is an off-topic post, do you see any good in clinicians these days, and what defines a good one in your eyes?

Thanks (hat tip). To me a good clinician is one who is

• pleasant to deal with (but not obsequious, passive aggressive or patronising)
• technically competent in their field (be that a nurse, or a Cardiologist)
• willing to make me a part of what's happening (even Vets do this with animals) should I wish that (surprisingly many humans do not want to face the demolition of their personal narrative and admit they are sick or suffering from a condition)

Just recently (you may have spotted the post) I had cause to wander up the road with a bleeding hand after a ladder collapsed under me. The clinicians (a pair of nurses and a young doctor) were great and we actually had a good laugh and exchanged stories. The young doctor who did the stitching was great and we swapped injury stories (if I can I'll preferentially see him again in future).

I've had quite a number of very good clinicians (but have equally had to steer away from others after the second visit).

I have had one notable example of one (who I discovered was infamous) back at Uni who was a neurologist ... arrogant, unwilling to listen, judgemental and only interested in cases who require his surgical touch (medication only cases were treated with disdain).

I think the ego can help the role of a surgeon.

indeed I believe its indispensable for both their success and their dealing with the reality of what they do. My own (most recent heart) surgeon is fantastic, he's not much with people skills or conversation (saying little, explaining some) but he is quietly spoken (but nobody speaks to him in a brusk manner a second time) and his heart is evident when he deals with patients. He elected to do the debridement surgeries of my post surgical infection himself and was very compassionate about the situation I was in (not just the surgical one). He uses his "leave" to go to poor nations (Bangladesh, Myanmar ...) to teach surgeons (which I only found out from a Ultrasound clinician (also very good) who usually goes with him).

He's an amazingly energetic man.

I've just read Henry Marsh's Do No Harm - British Neurosurgeon, who chronicles his career and lays out the good, bad and ugly - including cases where his mistakes lead to his patients dying on the table under his hands. It's very revealing.

it would be ... and personally I think it takes a bit of ego to survive that sort of thing (patients deaths).

I think it is indeed an art, however the art gallery that is the human body has rules - some which we know, some we are still learning, and some which are perhaps beyond reach? (consciousness, free will, love).

its is indeed a broad gallery with humans. This is one of the wonderful aspects of Teams. You can have someone with high compassion and someone with high skills and together the team succeeds in a way no individual ever could.

Henry Marsh dramatically says a surgeon must have the heart of a lion and the hands of a woman.

LOL, I'd agree with that, except for orthopaedic surgeons, they need the hands of a carpenter.

I hope I've clarified my position.

Best Wishes

 

[Wiles Darkwinter]

Hey mate,

Definitely wasn't intending on painting you with a broad brush, or any brush for that matter. Apologies if it came across that way - I'm Aussie too, and yes - have had the pleasure of travelling and working and serving with many people from many countries and our humour does often transcend above and beyond hahaha.

I also realise you do post quite a lot, and I only read what catches my eye on this site, so statistically I may just noticed a few posts of yours regarding clinicians and may have prematurely misfired my query...(think I need a urologist for that, not a heart surgeon?)

Anyway - very interesting response. I find it interesting to hear what people regard as a "good" clinical professional, as I am going to be one in the coming years. I'm hoping that having been a patient first will make me a more empathetic clinician. People often know what they hate, but not what they would like or prefer. People forget you have the option to leave the room (in most cases that aren't imminently pressing, and obviously only in countries where you have options) and if leaving the room isn't an option, inform the clinician what will make you more comfortable. Ask questions. Cite data. I think that makes for a better experience. I think my surgeon enjoyed having a two way discussion when it came to my surgery.

Cheers

 

[pellicle]

Mornin

Apologies if it came across that way

it was a figure of speech and I was not offended at all (certain chastisments by the moderation team however were utterly unacceptable in wording and approach)

I also realise you do post quite a lot, and I only read what catches my eye on this site, so statistically I may just noticed a few posts of yours regarding clinicians and may have prematurely misfired my query...(think I need a urologist for that, not a heart surgeon?)

I do my best to not assume people have seen what to me seems like my favourite harp top play

I find it interesting to hear what people regard as a "good" clinical professional, as I am going to be one in the coming years.

well firstly I agree, listening to others helps to break one out of the view that one is somehow "representative" ... secondly that's great and I wish you well in your new career choice.

I'm hoping that having been a patient first will make me a more empathetic clinician.

I'm sure it will, and having been a electronics technician before I did my electronics engineering degree I can say that years of field work meant that what was taught in class wasn't just "stuff I had to remember" it was actually answers to questions I'd puzzled over in years gone by. I believe it will help you to do well.

...People forget you have the option to leave the room

agreed, but if the person has no experience from which to make comparisons then they may just think this is "normal" and if the practitioner is smooth and engaging and presents the right way they may just grow into thinking that's "normal" too. Case in point was a recent back injury where I had to go through about 3 "physiotherapists" before finding one who:

• looked
• evaluated
• checked

and then gave a diagnosis. I was clear he was on the money within 2 days of doing the set exersizes.

I think my surgeon enjoyed having a two way discussion when it came to my surgery.

that's good and rare. My early surgeon (from childhood to adulthood) didn't mind that at all but I rarely did more than ask questions (as an adult, not as a child).

When I changed to his understudy he was very pragmatic, gentle of voice, logical but didn't seem to respond well to questions of the contrary (a bit like don't question my judgement). As it happened I didn't have much to ask about alternatives, because what he said seemed logical and while I wasn't "in love" with the idea of warfarin I was certainly not wanting to put my wife through a high risk 4th surgery.

My cardiologist on the other hand was very interested in what I was doing with INR management (to others, in Australia the Cardiologist has almost no role in this) and has always viewed with interest my spreadsheets (I take in my tablet for presentation) and is impressed with my outcomes.

Lovely chattin