Are we there yet?

“You have your way. I have my way. As for the right way, the correct way, and the only way, it does not exist.”
~Friedrich Nietzsche

Education is a wonderful thing. I learn something new everyday. Everyone from my patients, students, residents, nurses, and even the cleaning ladies, teaches me something. I truly believe that when I stop learning or wanting to learn, I should retire. While I love to learn, I also have the same passion for teaching. This is a double edged sword. The more you teach; the more you must know; the more you know; the more you realize you know nothing. This is a vicious cycle. How can you teach when you don't know?

Teaching in the medical field is tiresome. Sometimes I just want to do things myself, because it is easier and I don't have to think so hard or try to keep bad things from happening. I do realize that I have to allow the residents to grow and have to give the medical students some sort of education because they are paying for it. The whole process is taxing. Leading a service with medical students and residents is like being the lead car taking a caravan of cars through downtown Detroit. When you are leading, you have to drive slower than you usually do. If you see a stoplight turning yellow, you'd better slow down because not everyone will make it through the stop light. You'd better rethink passing that car because not everyone will be able to pass. Signal early so that everyone will know when you are turning. Don't forget about those potholes. For everyone in the caravan, it is stressful; but for the lead car, you have to anticipate what the needs are for the other drivers as well as try to predict how they will react.

It is my favorite time of the year, the end of the educational year, April-June. Everyone has a sense of confidence about them. From the medical students to the chief residents, everyone is spreading their wings and ready for the next level. It is when I have to lead less. My chiefs are leading the service without much need for our input; the mid levels are showing that they have advanced in both their knowledge and surgical skill; the juniors are making fewer errors and gaining confidence; and the medical students, well they just are nowhere to be found (just jokes). My least favorite time of the year comes right after this, July-September. It is like groundhog's day all over again. I feel like I am repeating myself. "I swear we just lectured on that." Or "I do it like I always do." I do realize that they don't necessarily know how I do it and others may do the same procedure differently. It can be a little frustrating. Usually I am whining, "Why can't we just do it like we did last time." It is probably more dramatic because it was so good a month or two before. We go from freshly paved highways to unpaved roads.

In my view, this is what keeps me on my toes and keeps me learning. The changes in residents and differences in experience help to enrich my experience. Yes, it is painful when I have to re-explain when and when not to brace scoliosis; or when I have to go over the different types of in-toeing for the millionth time. At the same time, those same residents and medical students question what I do and why I do it. It forces me to constantly re-evaluate what I do and why I do things the way I do. As much as many resident and medical students complain about attending pimping, all those questions you ask are like reverse pimping. Sometimes I want to shout out like a parent, "Just because that's the way I do it." As much I (attendings) am there to help in their (medical student and resident) education, they prevent me from getting stale and set in my ways. It makes almost everyday interesting; every case a little different; and every patient special. To those who are graduating, thank you and lead well; and to those who are entering, welcome and watch for the break lights.

“For everything you have missed, you have gained something else, and for everything you gain, you lose something else.”
~Ralph Waldo Emerson