Last Friday I had the privilege of leading our resident education session.  We spent 2 hours together learning how to become better educators.  I say ‘we’ because, despite being in medical education for the last 12 years, I still have a lot to learn about teaching.

I think for a long time I bought into the myth that anyone can teach.  And that anyone can be an excellent teacher.  Like once you have mastered a subject, let’s say addition, that you will be great at teaching addition.  Well, you’re not.  Or at least I’m not.  I can distinctly remember my oldest child attending preschool and being sent home with a packet of sight words.  Until that time I had no idea how children would get from having a cry or smile as the only method of communication to speaking, reading and writing complex words.  Thankfully my child’s teacher knew the path.  In fact, her 2nd and 3rd grade teachers have more experience teaching than I have in being alive.  They knew where she had been and where she was headed in her educational journey.  And her 4th grade teacher will as well.

I teach adult learners.  Medical students and residents.  Medical Education is wonderful and also amazingly challenging.  When a new 3rd year medical student begins with us they have literally spent about 25 hours per week in the classroom in addition to the dozens of hours a week they spend studying in the library.  They soak up all the knowledge you give them.  They are early in their journey toward their final career goals and eager to learn all that medicine has to offer.  They want to know their patients and help create tangible positive outcomes for them.  My residents spend even more hours at work and in the learning environment than the medical students.  They are responsible for patient care as well as a huge chunk of the medical student education as well as making sure they learn all they can before leaving the training environment.  It’s a lot to accomplish.

What I have learned in medical education is that being a teacher is a huge responsibility.  It isn’t enough for me to have passion for the subject matter.  I have to translate that passion into meaningful experiences and into a format they can understand and retain.  It means more than just making sure the medical students know the basics about caring for women; it means that we have taught them how to have respect for their patients, to care deeply for the broken and hurting around them and to find a way to always have compassion.  The challenges come when you are consumed with your own work and you find it hard to stop and teach someone else.

I think this is a challenge for everyone in education.  Teaching is hard.  Being an excellent teacher is even harder.  For me, I stay in the Medical Education environment through the struggles because I remember the faces of the teachers that taught me empathy and compassion, because I still have a lot to learn and those medical students and residents challenge me daily to be better than my best, and because I hope that my community and my state are healthier and better cared for through the work we do in our teaching institution.

Hug a teacher you know. Hug all the teachers you know.  Or bring them a snack or send them a note of encouragement.  They leave each day having given all they can to some who will receive and some who might not.  They are not only teaching subject IMG_2943matter they are often teaching the life lessons of respect, empathy, compassion and kindness even when their own runs low.  They are the feet with which He is to go about doing good.  They are caring in places many of us would not dare to invest.

And if you know a medical student or a resident physician, give them a hug too.  Or maybe a cup of coffee.  They are always being challenged to learn more and do better. They spend themselves each day to do their best for others, using their hands and their heads and their hearts to care.    They teach me something every day and for that I am grateful.


what we don’t know.

At lot of medicine is about what we think we understand to be true.  We use the best available evidence, if there is evidence available, to help patients make decisions about their care and to manage disease to the best of our ability.  (I previously posted on this idea of evidence based medicine.)  I think most of life works this way.  Our minds compile what we think is the best available evidence to make decisions.  Like when I go to the grocery store.  Which package of strawberries seems to be the brightest, which milk carton expires latest, what granola bars my kids will eat this month.

But there are some things that we don’t have much evidence for.  Sometimes this is because we don’t have much experience or research with the problem.  Take, for example, the Zika virus.  Although the Zika virus has been around for some time, we have very little experience and research with the virus when it comes to adverse pregnancy outcomes such as microcephaly, miscarriage, and other complications in pregnancy.  You see, what was first noticed was an association.  A large number of women who had been exposed to the virus or were known to have the infection had babies born with microcephaly, or underdevelopment of the brain.  Does association mean causation?  No way.  So scientists from the CDC and other organizations began to explore how these two things were related.   For many other infections a pregnant woman might be exposed to doctors can give a significant amount of information to their patients about the risk to your baby depending on when you are exposed and other laboratory findings.  But for Zika we don’t know that information.  We have limited data that would say about 1/3 of pregnant women infected with Zika will have some kind of adverse pregnancy outcome.

So what do we do?  Well, the CDC says if you’re pregnant just never go outside. (I can hear you laughing all my pregnant ladies.)  We tell our patients to use insect repellent with DEET, to avoid travel to Zika infected areas while pregnant or for at least 6 months prior to attempting pregnancy and don’t have sex with men who have been exposed to Zika or have travelled to Zika infected areas if you are pregnant.  We have no vaccine; we have no treatment.  But, hopefully soon, we will.  Researchers will continue to work on how the virus is transmitted, why certain women’s infants are affected, and how to prevent or treat Zika before it becomes an even bigger health concern.

The other issue I’d like to address today that we don’t know much about is gun violence.  Oh yes, I went there.  You see the CDC has had a self imposed ban on gun violence research since 1996 when its funding was threatened.  It has been more than 4 years since Sandy Hook and only a week since the Orlando night club shooting.  Two large bills to fund gun violence research have failed to pass.  Is there some research out there on gun violence? Sure.  But consider this: if you do a PubMed search on Gun violence you will find about 1500 scientific articles or editorials on the topic.  If you do the same search on autism, you will find over 34,000 articles on the topic.  Is autism research important?  Absolutely.  Should we have the opportunity to publish over 30,000 more papers on gun violence?  Absolutely.  Because I can’t tell you if more guns or less guns or safer guns or more training or anything will keep men women and children from being gunned down by individuals hell bent on destroying the world around them but unless we try and find out what we can do we are powerless to do anything.  It’s like telling pregnant women not to go outside or just avoid travel to Zika areas…sometimes you need to go outside and Zika might just come to your area.  And then you need to know what best to do for yourself and your family.  You need to know what you don’t know.

So, on this Father’s day, I am thankful for a father who loved to hunt but always made us feel safe and secure when we went with him.  For a father in law who loves to travel and has been generous to take us with them.  And for a husband who loves his daughters, and everyone else around him for that matter, enough to work hard to bring more peace to the world on a weekly basis.

(photo credit to @jonmsutton on twitter)