Doctors Don't Know Everything

6:40 AM

“Doktor perubatan bukannya tahu semua ilmu alam ni. Jangan sombong sangat.”

This is a common sentence used to kill off any educated discussions. Doctors are arrogant, thinking that they know everything. Doctors fail to realize that with the information technology revolution, knowledge is at everyone’s finger tips.

“Semua orang boleh belajar ilmu. Tak perlu susah pergi ke university, banyak seminar dan online classes yang boleh ajar.”

“Bila pesakit tau lebih sikit, mula la gementar. Saya banyak dah baca online. Ilmu saya boleh sama tahap dengan ilmu doktor picisan yang mentah.”

All of these accusations are actually far from the truth. The fact is, as you acquire more knowledge in the field of medicine, you realize how small you are in this universe. You will realize that you still have much more to learn. Medicine is an endless pursuit to understanding the human body; it’s function and disease processes.

Six years ago, I encountered a patient who almost bled to death due to oesophageal varices. It was my second day of work. I was a ‘newborn’.
I KNEW everything about shock. The patient was in haemorrhagic shock.
I KNEW that he needed blood transfusion.
I KNEW he needed to be intubated with a size 7.5 ETT anchored at 22 cm.
I KNEW he needed CPR. Chest compression at 100 compressions per minute, 2 inches depth, allow full recoil.
Yet, I did not do a thing. I waited for other senior doctors to guide me.

Today, I will DO CPR. I will DO the intubation myself. I will DO everything to save a life!

Notice the difference between KNOWing and DOing? When I KNOW something, it doesn’t mean that I can DO it. What links the two words is EXPERIENCE.

I may know how to pilot an Airbus A330 by installing a Flight Simulator on my PC. But can I really pilot a plane? How does a 2G force feel like? How much force should I apply on the control stick to make a smooth turn? How does it feel being responsible for the life of hundreds of passengers and crew?

I can learn to drive anything in GTA
EXPERIENCE is what makes a cardiologist a specialist in cardiology. In terms of knowledge, a 2nd year medical student may already know everything about the anatomy of the heart; the circulation, the pathology of a coronary heart disease and the cellular structure of a myocardium. Can the medical student know how to treat a patient?

EXPERIENCE makes doctors fear for the well being of the patient.

EXPERIENCE makes a doctor worry when a 32 weeks pregnant lady has a blood pressure of 140/90 mmHg with headache and proteinuria. She can get into a seizure (eclampsia) at any moment.

EXPERIENCE makes a doctor prepare for the worse when a lady with retained placenta post partum has tachycardia despite a normal blood pressure. She can progress to disseminated intravascular coagulation in less than an hour.

EXPERIENCE makes a doctor worry when seeing an 8 months old boy with fever have sunken eyes, capillary refill time of 5 seconds, weak pulse volume and not cry. He is severely dehydrated.

Picture from The Free Dictionary
Sometimes, I hate being right. I never want to tell anyone “I told you so” when it comes to a medical illness.

I hated it when I was right in telling the patient that refused to take his anti hypertension that he will succumb to stroke. That patient had a haemorrhagic stroke and never regained consciousness.

I hated it when my patient died due to uremic encephalopathy after being discharged at his own risk from the ward. I was the one who got his son’s signature for AOR discharge, and unfortunately I was the one who had to perform CPR inside a lift upon his readmission (on his way to the ICU).

I hated it when a young 17 year old boy had to be readmitted for an open fracture of the tibia after he was brought to a traditional healer. He had a close fracture on his first admission. His father insisted that the boy didn’t need a POP.

An open fracture

A colleague of mine hated it when a baby died because of Hemorrhagic Disease of the Newborn, despite it being preventable. The mother refused IM Vitamin K prophylaxis injection for her child. She was quoted as saying “Doktor tak terangkan kepada saya” even though it was clearly documented that she was informed of the risks and will take full responsibility for her actions.

I won’t end my entry with a #jangankecamsaya. I know some people WILL kecam saya. I leave it up to my readers to decide. Some of these anti-whatever-the-professionals-say already made up their mind. You can give all sorts of educated reasoning and they will say otherwise. You can give 1000 studies that show a method works, and they will highlight the ONE study that shows some sort of link to an adverse affect.

Share this to entry to your friends that are on the fence on anti-whatever-the-professionals-say issues. This is not a good read for those who have made up their minds on being an anti-whatever-the-professionals-say.

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  1. So true... What we learn in med school is just only the barest minimum for us to survive in the real world where experience counts. Drs must be humble and don't fall into the trap of knowing it all.

  2. melayu piang sebok pegi bomoh..mne nak kisah ilmu perubatan..bomoh kan pandai "perubatan Islam" setelah bertapa bogel kt hutan seminggu..apa barang medical degree..perubatan moden tu semua kapir punya agenda nk jatuhkn Islam..tgk Ulama2..bila diorang sakit diorang x pegi hospital kan? puuiii...


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