Asking why

Did a ward round with one of my first rotation FY1s today......who is now coming up to his final couple of months of his first year of training. It's always a pleasure to ward round together even if it is a rare occasion. I should be grateful I have swapped well today!

My usual working rule with any weekend medical ward round.....'I will create little work, enough clarity and coffee'......I don't think I broke that rule today 

It did give us some time to chat on a number of topics including Eid, senior medical decision making (and the makers) & my own process of decision making..

Eid came up as we have similar conflicting emotions, mine related to being a reflective one & memories of those in the past & his on his thoughts on the ongoing admission of a relative in hospital. Hopefully shared experiences makes a burden seem less cumbersome. it doesn't take away that the lived experience of seeing a relative in hospital is an eye opening one!

It made me think what makes us the medical decision makers we become?

We are do come through different schools of thoughts!

My three processes included observation, learning & unlearning 

• Observation through watching that first consultation as a doctor done by my first boss and how to do it well

• Observations through the conversations that made my heart sink, the one's when I held back from the rest of the ward round to finish the unfinished conversation

• My observations of my emotions when I saw the first patient who turned away from me & the first of many angry relatives who walked away from me

• Learning from the ward rounds be that on a long day take, the one after a night shift & the ones where I led on them.

• Learning to be comfortable to ask 'why'.....this was a work in progress as a lot of this was questioning more in my mind than allowing the words to actually be expressed. I didn't think I could ask why

• Unlearning my bad habits, my biases & fixed beliefs

My processes now still are the above 

• Trying to understand a fellow clinicians clinical reasoning & still asking why. I'm more assured in the latter!

• Understanding and acceptance my own clinical reasoning will get questioned

• The learning from discussing cases with my chosen trusted peers. I know this has taken time but finding this circle is important

• The learning from the cases I discuss with the residents & explaining the decisions I take

• And yes.....I'm still unlearning fixed habits and biases!

We all have our nemesis's in medicine but also it's important to find our allies.

The support mechanisms around tackling our nemesis is through shared learning, shared experiences & being open to asking 'why' 

I haven't stopped asking why yet. This might make us seems vulnerable as clinicians but at least we might come across more human & accessible to our residents and those professionals we do work with. 

You never know...they might talk to us more about their vulnerability in their professions & become comfortable to asking why.

The sky was certainly conflicted this evening but if anything it's never less than enigmatic, a bit like medicine 

Until the next ward round......