A Stitch in Time: Embracing My Limits as a Medical Learner

To the Editor: Many believe that physicians are perfect, all-knowing beings. Despite having heard about clinical errors through news media, I also subscribed to this belief, and, consequently, carried a philosophy of perfection into my first clinical observership as a medical student. The physician I shadowed, a family doctor operating in a rural community, occasionally asked me about the patients’ cases, and I felt accomplished when responding correctly to the questions she fired. Then, she threw a curve ball. The next patient was a child who cut his leg, and the physician enthusiastically prompted me to suture the wound. For some, suturing a one-inch cut might be banal. For me, it was daunting. In all my three weeks of medical school, I had not yet learned about suturing. I was clueless, yet refusing seemed unviable. The family physician continued pointing the needle driver toward me, repeating that it was an easy procedure, something that I should know how to do. As I reached for the needle driver, I looked to the boy, finally noticing his terrified expression. I was so preoccupied with my own thoughts that I had neglected the patient. He deserved my honesty. He deserved quality care. My throat unfroze, and the words finally flowed: “I don’t feel comfortable doing the sutures. I’ve never done it before … but I would appreciate if I could watch how you would do this.” I waited for the physician’s reply. How incompetent are you? Are you really a medical student? You should know this already! You should consider another profession! I braced myself for the harsh criticism, but it never came. Instead, the physician apologized for assuming that I was comfortable with treating the patient and started explaining what to do. This was my first instance (of many) of admitting my inability to perform a task. Despite the family physician’s understanding words, I felt frustrated and embarrassed. However, it was these emotions that ultimately prompted me to improve my knowledge. Later that week, I began watching YouTube video tutorials on suturing techniques, and I registered for an upcoming surgical skills workshop. I believe that physicians have an innate desire to seek perfection, but no one is born knowing how to perform a cardiac exam or how take a social history. We all need first experiences to learn and grow, and admitting our limitations is essential for discovering our starting points. Jeffrey Lam Shin CheungFirst-year medical student, University of Toronto Medical School, Toronto, Ontario, Canada; [email protected]

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