seven word reflection

I came across an interesting way of encouraging free association – close your eyes and open a book at random, put a finger on the page, and open your eyes. Take the three words before and after the word, thus getting a seven word phrase. Start writing, trying not to censor or direct your thoughts.

This is my first piece:

Seven word story.

 ‘Native intelligence and hard labour a degree’  – did I hear correctly, did he really say that native intelligence and hard labour were worth more than a degree? I could hardly believe my ears, but given the latent resentment of the ‘academic elite’ that he admittedly managed to keep under wraps most of the time, together with the equally well hidden misogyny, it would not have been surprising if he had indeed spoken those words.

A deep suspicion of academia from those who are themselves highly qualified may seem strange, but in my experience many doctors hide an insecurity about the intellectual rigour and lack of breadth of their postgraduate education behind a veiled contemptuousness for academics. After all, what do these people really do, with their thinking, debating, writing and publishing, or God forbid, creating art and exhibiting. Doctors save lives, face the nitty gritty of the suffering in our society on a daily basis.

On this basis doctors might reasonably claim to fall into the fraternity of hard working people with considerable native intelligence, rather than the community of philosophers and artists (among others) who are more interested in the bigger picture, the existential questions.

What I find curious (after a long career in medicine and a shorter one in the arts and humanities) is the extent to which doctors have successfully deluded themselves. Most consider themselves well educated, confusing (along with Ian Duncan Smith) ‘well educated’ with ‘successful well paid career’. They assume that four grade A or A* A levels and a five year medical school training makes them well educated. The clues are in the names – medical school and training. Although contemporary medical undergraduates have less of a ‘pot filling’ course than 25y ago, and have some input from the arts and humanities, the emphasis is still on transmitting a great number of facts, and later differential diagnoses, to these embryonic doctors.

Postgraduate examinations retain the same emphases on basic science and clinical practice – and I am not arguing with this in principle (arguing about the actual examination system is for another day).

Perhaps it doesn’t matter that our doctors have what remains in effect a high level apprenticeship training. Holistic medicine was a fairly new concept when I trained, and my medical school was considered innovative in its curriculum. Holistic medicine (in mainstream medicine) has been a casualty of the post Thatcher years as the art of medicine has steadily been crushed by the relentless march of evidence based, reductive medicine. Outcome measures and the search for certainty are the twin goals of today’s doctors, and more importantly, today’s health politicians.

I would argue that it is more important than ever for today’s doctors to be well educated in the true sense. Of course they need their factual medical knowledge and skills, but they also need inquiring minds. Not inquiring only about the patient’s symptoms, but also inquiring about the patient’s world. This requires empathy, a skill that can be learned and developed, an ability to know oneself and put oneself in another’s shoes. Wider inquiry requires the intuitive knowledge that comes from reading widely outside medicine – good novelists, poets, playwrights. Intuitive knowledge comes from watching films and reading newspapers properly, and discussing them. Real education comes from opening one’s mind to new thoughts and ideas, and then really thinking about them.

So to return to the fragment that I overheard, no I don’t think that native intelligence and hard labour are worth more than a degree. Nor are they worth less, but some professions demand hard work, intelligence and lifelong real education.

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