I get annoyed, embarrassed, and irked by my ignorance of so many aspects of today’s medicine. As they say, you could fill a textbook with what I don’t know. As a matter of fact, you could fill two. One is called Cecil Textbook of Medicine and other is called Harrison’s Manual of Medicine.
While my foibles on rounds can be amusing, there’s a serious side to what I do. In admitting ignorance, I’m trying to teach the house staff some lessons. Most important: if you don’t know something, ask for help. Others include don’t be proud, act with understanding, and be honest in the face of change.
The inpatient ward is a special environment that exists at the extreme edge of medical practice. Education starts there because it is best place to learn. The stakes are high; indeed, they are matters of life and death. Because the consequences are dire, mistakes are remembered, the recollection of serious error a spur to maturity.
The month on the ward gives me a reality check on what we, as physicians, know and what we don’t know. In looking at some recent events affecting rheumatology, I worry that some physicians are not heeding the lessons learned on the ward and are disregarding the limits on their knowledge.
In future issues, I will discuss this matter further and give you my own take on situations where asking for help could go a long way.
Dr. Pisetsky is physician editor of The Rheumatologist and professor of medicine and immunology at Duke University Medical Center in Durham, N.C.
