I see a fair number of doctors every year because, you know, chronic illness.

About half the time, they have residents or students with them.

I enjoy being a part of their education and training because that also happens to be my job. 🤓🤓🤓 1/12
I also understand how things are made.

When I eat a salad, I know human beings cut those greens in a field. Food doesn’t walk to my store. It’s grown and harvested by people. Then washed, shipped & handled by others.

I respect the people involved in the things I consume. 2/12
The people that make and do and grow things for me to consume are human beings.

They are not printed in a factory and they aren’t grown in a lab. 3/12
Like me, they started as novices and became masters.

With time, training and practice. 4/12
When I engage with the world and its people, I recognize training everywhere. I recognize my role as a consumer but I also have a role—a responsibility—in education and training others. 5/12
I know people who view the world a different way. They feel that they deserve to be served only by masters at the top of their craft.

Everyone who makes or does or treats them must be experienced and at the top of their game. 6/12
Hidden in this attitude is something I find despicable.

It is the attitude that novices should practice on “other people.” 7/12
People who refuse to be cared for by newbies want the newbies to practice on someone else.

Who? Poor people. Marginalized people. Unimportant people. People of color. Someone else. 8/12
This attitude of superiority is reprehensible to me. I do not engage with the world to take its best and leave the rest for people less fortunate than me.

I don’t believe there is a category of people who deserve to be used for training doctors. 9/12
I believe we all owe a contribution to training new people in every field, knowing that training is essential in the process of achieving mastery and making experts. No number/
To me, letting rookies learn while caring for me is like any of a thousand other small sacrifices I make in order to be a part of the world instead an exploiter of it. 10/12
Not littering on a street I don’t live on.
Taking a vaccine.
Following the law of the land.
Considering the feelings of strangers.
Letting people off the elevator before I get on.
All these things are responsibilities I accept. 11/12
I’m not here to get the best for myself.
I’m here to engage with a world that is always learning and training and becoming more capable.

Sometimes I get a master and sometimes I get a student. This is the inevitable truth of engaging with a real world. 12/12

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More from @medicalaxioms

9 Apr
I round at the bedside and also do most of my teaching in the patient rooms drawing on the window with a dry erase marker.

I get A LOT of compliments from patients about
- showing them how we think about problems
- how smart the team member are
Patient like to see how hard we work to solve their problems and also how much of their story and details we keep in our heads each day.

I can only recall once in 10 years when a patient asked us not to teach and discuss in the room. It was last week!
He said, “Will you stop talking and fix my problem??”

A few days later we were drawing on his window and he said “Am I your favorite patient?”

I had to be honest that we teach and learn in every patient room just the same.
Read 7 tweets
7 Apr
I don’t care if you don’t want a COVID vaccine.
Your reasons don’t interest me.
Your theories are irrelevant.
Read 7 tweets
31 Mar
We teach wrong when we teach residents to write elaborate notes. 1/many
Doctoring is not performed in front of a computer in a work room. 2/I’m going off
Every extra minute spent writing pretty notes is a minute not spent

- solving the sick person’s problem
- learning about the disease, it’s diagnosis and treatment
- discussing complex medical decisions with colleagues

And most importantly

- talking to your patient 3/
Read 13 tweets
30 Mar
Abandon shitty decisions early.
Don’t throw good money after bad.
Cut your losses.
Read 4 tweets
20 Dec 20
If a patient is having trouble getting along with staff in the hospital I sometimes take the time to teach them how to get the best care possible in the hospital. 1/
First you get to know the names of all the people taking care of you. 2/
Understand while they are here doing their job and treat you with courtesy and respect they are also human beings who appreciate being treated with courtesy and respect. 3/
Read 9 tweets
19 Dec 20
Somewhere in the last few months I unfollowed or blocked the lynchpin of social media crazy and now they’ve all gone away.

The antivaxxers, flat earth, fluoride is poison, 5G, COVID’s a hoax. All of them. Gone. All I see day after day is normal, logical, scientific opinions.
I wish I knew how I closed the wormhole to Tinfoil Hatland. It’s become so pleasant here where reliable people depend on other reliable people to render reliable opinions.
Alternatively, maybe I silence the people who are full on 🍌🍌🍌 so fast and so effortlessly that I just keep screening them right out of my sphere of attention. 🤔🤔🤔
Read 6 tweets

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