Learning the hard way

"Doctor I think there's something in my eye..."

I'd just put the finishing touches on my first 6-0 facial stitches. My preceptors had been harping on me for a long time about how hard it was to use 6-0 stitches (it's not), and how important it is to stitch properly on a face (it is). My job today was made slightly more difficult because my patient was a 19 year old girl who had previously had an injury to her face that had not healed well.

So when I'd closed up her forehead and sent her away with the right instructions I was feeling pretty good about myself. I'd done an impressive job in my opinion, I'd properly disposed of all my sharps and strode out of the surgery room a little more confident in my skills and a little less inept.

Five minutes later the ward clerk chased me down and gave me grief because I'd sent my patient home looking like she'd walked off an excerpt from the next Fox special "When Prison Riots Go Wrong". In my excitement over another suture technique to add to my arsenal, I'd forgotten to wipe off the excess blood off the patient's face. For some reason, foreheads bleed like stink and the nurse wasn't going to let me forget about this one.

Such is learning in clerkship, at least for me that's how learning is done. I don't know the answer to a question, or I don't know how to do a procedure, and I go look it up later. I get chided for doing something improperly or I nod sagely through a conversation that's completely over my head, and I go look it up later. The path to enlightenment appears to be littered with those times when you fall flat on your face with everybody watching. Shamed into learning! It's the best way to remember your lessons. It's embarrassing, but it works.

It's so easy to identify the people who are going to be star doctors someday, catering to Bill Clinton's quadruple bypass, Kirstie Alley's stomach stapling, and when the other shoe drops, Britney Spears' medically supervised methadone usage. Those clerks are the ones that know the answers before the questions are asked, the ones that never have to be bailed out of a jam, the ones that seem to never have to study. I don't know how those people learn, unless it's direct download into the USB port they have secretly installed in their rectums.

Learning. Digital, or humbling.