14 Oct 2010


To the student’s question, my simple answer was you need to have priority.

A few years ago, a first-month resident mentioned she could not see all emergency cases at night and had some left unattended for quite a long time. Half jokingly, I told her, “In such situations, you have two choices. You may clerk full history and provide flawless management to some patients and let the rest run their natural course including death. Alternatively, you may provide ‘basic life support’ to all patients and make sure they make it to the next day, when the parent team takes over the care.”

Of course, this deviates from what a sensible person should advise. The textbook answer should be “We work as a team. You should ask your second-call (or consultant, COS, HCE, etc. depending on whether you live in Pluto or outside the Solar System) for help when the case load is high (which literally means every night).” Nevertheless, I mean it. We should not play God. We do our best, but should at the same time understand our own limitations. For one thing, our time is limited. An extra hour spent on one patient means one less for other patients. We spend more time on a patient when necessary, but judicious planning on time and resource allocation is equally important.

This month, a new group of students joined our ward round. Suddenly, AL explained that we were having busy business rounds and sent them away. As a teaching staff, I should have stopped her and encourage students to join clinical activities. However, I was too surprised and became speechless.

Perhaps that was very Freudian.

The spirit indeed is willing, but the flesh is weak.

P.S. Students, ignore the above. Of course you are welcome to join.

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