The Educators' Pause is a regular column for the CHA Academic Newsletter. It has three components:
A Story: about a meaningful moment in medical education
A Question: that invites community conversation
A Conversation: Select reader reflections will be shared in the subsequent installment
The Story: How My Vacation in Germany Rekindled my Childlike Wonder of Medicine
For two weeks this August, I fully unplugged from work and travelled with my husband and two sons, ages 4 and 2, to Germany. My husband spent every summer of his childhood visiting the Bavarian farm town where his mother grew up as well as the surrounding cities, villages, and mountains. He planned an itinerary that would introduce our boys to castles and medieval cities that had ignited his imagination as a child.
I mostly took the backseat on planning. But while we were in the city of Würzburg, I learned that this was where physicist Wilhelm Conrad Röntgen (1845–1923) discovered x-rays, for which he was awarded the Nobel Prize in 1901. The university maintains a small museum in its former Institute of Physics dedicated to this discovery and its impact on the world of modern medicine. I needed to go. Not just to learn, but to pay homage. Imagining my job as a pulmonologist and intensivist without x-rays and CT scans (which use x-rays) is impossible. Beyond being a critical diagnostic tool, the ubiquity of x-ray technology has fundamentally informed how I conceptualize the human body. And so we went, double stroller and all.
My four-year-old and I have talked about x-rays before. When he was two he fell and broke his front tooth straight down the middle. I snapped a photo of the x-ray the dentist took and included it in our family photobook. I’ve explained how this special picture lets us see the part of his tooth that is behind his pink gums. I’ve told him that x-rays of patients’ chests and lungs help me know how to make them feel better. And so it was perfect that while in Würzburg we could learn about how a person with intense curiosity and deep commitment figured out how to take these pictures.
Presenting the history this way, it felt magical, just like the castles and shining armor of knights we saw elsewhere on our trip. It’s a kind of medical history I generally avoid. As an amateur historian, I’ve spent time in archives learning about the first ICUs and the early AIDS epidemic. I’ve always been more interested in the social construction of medical knowledge, how ideas about gender, race, and sexuality inform what is presented as hard fact, than in what individual people have discovered or invented. And yet here I was, enthralled to learn about Röntgen and his discovery.
And so in Würzburg, while technically unplugged from work, I imagined myself back in the ICU where I teach our residents. I wondered if I’ve neglected to impart this childlike sense of wonder at the science of modern medicine. There is so much wrong in our increasingly corporatized and inequitable healthcare system about which I can speak ad nauseum. And yet, when I stop and think about it, that we can take pictures that allow us to see inside the human body is nothing short of remarkable. Perhaps “stop and admire the x-ray” is a worthwhile mantra for the modern clinician.
Community Question: What in medicine ignites your childlike sense of wonder? How do you share that with your learners?
Discuss the question with colleagues and learners!
And I’d love to hear from you! Reply here with your reflection- to update link here (you can do so anonymously if you prefer).
Top photo: The room where Röntgen conducted his experiments. Right-hand photo: My kids listening to a recorded interview with Röntgen
Community Responses from the last Educators’ Pause Reflection Question:
The question: Recall a time when you learned to center the patient and not their disease. What helped or got in the way of learning that lesson? How do you convey this lesson to learners?
To update here: “I was a Chief resident in Surgery making rounds on patients. We came to a patient who had surgical drains. The kind that go to bulb suction. I prepared the patient and got ready to pull the drain. I had cut the stitch holding it in place and I popped or opened the bulb to release any suction in the tube. As I was about to pull it to show the Interns how to do it. Something I had done 100 times by my Chief year. An intern said to me…”there’s still negative pressure in the tube” I said “no there’s not”. He grabbed the suture scissors and cut a small Knick in the tubing and sure enough some pressure released and it decompressed the fluid in the tube. It really surprised me. That's when I thought to myself. Wow you think you know everything and every once in a while someone new, even an intern, can teach you something.” –Albert Ko, Staff Surgeon
To update here: “I've recently started precepting residents in the primary care clinic, 15 years after I myself finished residency. It's given me a perspective on the depth of our specialized knowledge and the time it takes to learn what we need to know as clinicians. I've been struck by how often I've heard from a resident "This is the first time I've seen this" - sometimes for very simple things, say sinusitis. It's given me pause to reflect on the breadth of knowledge needed in our profession, and the the long learning curve we're on to earn that knowledge” –Joel Sawady, Primary Care Physician
To update here: “As an attending, in many cases, I get quite jaded… External concerns get a foot in the door and then cynicism throws its entire grim nature straight through the opening. Everything becomes dark. The ultrasound shows flickering shadows, but I cannot find my needle. The easiest way for me to resist that and to ground myself in the moment is just to sit back and let the residents talk. The CHA residents are so often present, so often bursting with compassion. I can use that as a guide wire and find my way back to my own cavo-atrial junction.” –Lakshman Swamy, Pulmonary and Critical Care Physician
Bio: Colleen Farrell, MD, is a pulmonary and critical care physician, medical educator, and writer. She teaches CHA residents in our ICUs and Harvard Medical students in their medical ethics courses. Her reflective writing on medical training and practice has been widely published and is available at colleenmfarrell.com.
