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Medical Education, Beware the Hidden Curriculum

The hidden curriculum is taught by the school, not by any teacher…something is coming across to the pupils which may never be spoken in the English lesson or prayed about in assembly. They are picking-up an approach to living and an attitude to learning.

-Dr. Roland Meighan

16 Stories of the Patient Knowledge Gap

Some of the initial questions I ask a patient are: What brought you into the hospital? What can I do for you today? Tell me your understanding of what is going on?

These questions often sound so arbitrary and so redundant given what are generally provided to us before we even see a patient: We have reasons for referral written in the chart. We have the verbal handover from another physician. We make assumptions of affluence based on a person’s appearance.

However, it is always surprising how often there is a disconnect. For example, I once treated a patient who was a retired internal medicine doctor per the chart. Even as I spoke I realized that he was not following the medical terminology. It turned out afterwards that partly this was due to a language barrier (he was a physician in a different country), he had been retired for many years, and partly because he had some early dementia.

As the stories above illustrate, it never hurts to ask before starting.

Essential Anatomy 3 for Android

For a limited time only, Amazon is giving away Essential Anatomy 3 for free for the Android. If you have not had a chance yet to check out this stellar educational tool, go check it out. This is typically a $25 piece of software.

Sierra Leone is on the lookout for an Ebola-positive patient on the run

Officials in Sierra Leone’s capital are trying to find a woman who left a hospital with the help of her family after testing positive for the deadly Ebola virus. The 32-year-old woman, whom radio stations in Freetown named as Saudatu Koroma, was being tested for the virus in an isolation ward, then was “forcefully removed” by her family, Reuters reports. That’s led to a hunt for Koroma to keep her from spreading the virus to others.

Busy Doctors, Wasteful Spending

There is no more wasteful entity in medicine than a rushed doctor.

Computer spots rare diseases in family photos

Doctors faced with the tricky task of spotting rare genetic diseases in children may soon be asking parents to email their family photos. A computer program can now learn to identify rare conditions by analysing a face from an ordinary digital photograph. It should even be able to identify unknown genetic disorders if groups of photos in its database share specific facial features.

HIV, AIDS ward closes at St. Paul Hospital due to decline in disease

The HIV/AIDS ward at St. Paul’s Hospital is closing due to a decline in the once-deadly disease, the B.C. government announced Tuesday.

“This is a proud day for British Columbians as we mark another milestone in our leadership in the fight against HIV/AIDS,” said Premier Christy Clark.

“Thanks to the dedicated efforts of the community, those at the BC Centre for Excellence in HIV/AIDS and health professionals across the province, a ward that once served those dying from AIDS, now supports those living with HIV.”

Modified measles virus destroys cancer in early clinical trial

Promising early results from a clinical trial at the Mayo Clinic out this week suggest that a modified version of the measles virus can be used to target cancer cells and put the condition into remission.

The Day I Started Lying to Ruth

A cancer doctor on losing his wife to cancer.

A year ago, after a busy night on call, I received a phone call from my mother. Instead of her usual self, she sounded anxious, with an urgency in her voice I seldom hear. I would learn that a close friend of hers had just been diagnosed with cancer.

"Do you know anything about it?"

As one of the mandatory components to our curriculum  I certainly knew it in broad strokes. It was this education that allowed me to deduce based on some of my mother’s description of her friend’s results and symptoms, that the prognosis was poor.

"Yes, I do."

I wrestled with myself over the phone. How much should I say? How little? Was it my place to say anything at all? But my mother was worried for her friend. Having lost my father to cancer only years ago, she wanted at least some reassurance.

Even despite my limited experiences as a student though, I knew I could not offer any. I hesitated.

Instead, I put on my suit of armour that was my white coat and spoke objectively about what the results were, what the symptoms meant, and what the doctors may offer her in the coming weeks.

"But I do not have the full picture." I cautioned. "Her doctors are there evaluating her and this is obviously their specialty." 

In a way, I was trying to wash my hands of the responsibility. I did not want the burden of knowledge that I now possessed that my mother desperately wanted. I answered her questions as best as I could. Intent not be optimistic or pessimistic.

But people always hear what they want to hear. She felt that there was still a possibility of a reversal. A recovery. A new lease on life. She just was not ready to go through everything with my father all over again. I could not muster up the strength to say anything in return.

When my father was diagnosed with cancer at the end of his days, I knew nothing about it. I was the ignorant and oblivious observer. I could still hope. I could still maintain optimism.

But now, armed with a wealth of knowledge, I fear the day when I must confront a similar situation again. When I can understand the disease, interpret results, and foresee the future. It is both a power and a curse.

Some day in the distant future, when all of my family members turn to me for guidance in those dark hours asking those questions that nobody ever wants to ask or answer - “How is he doing? Will he get better? What can we do?” - I hope I have the courage to say what is right.