Who is the Teacher?

An older man walked in, with gray hair that was balding on top and a smile that seemed to mask an infinite wisdom. As he approached the podium, it appeared as though this lecture would be typical: interesting ideas, just nothing a freshman in college would remember for long. The man was a philosopher, although he began his journey as an engineering major who was going to be an astronaut. He had a science background, but he had found that something was missing. Philosophy proved to be the missing piece. As he drew a complex scribbled figure on the white board behind him, the room fell silent.

“Students, many of you are science majors, and throughout the next four years you will learn this. All of the biochemical pathways involved in digesting food… let’s say a piece of chocolate.” As a young biochemistry major, I was unnerved at the complexity I associated with biochemistry, but I also felt a yearning to hear where this was going.

“What you will not learn, however, is what that piece of chocolate actually tastes like,” said the wise professor. This lecture would stick with me from this point on. Maybe it was because I loved chocolate, or maybe it was because the idea of living a life full of knowledge, but also full of experience, was something I was subconsciously seeking. I could see that medicine would allow me to explain the biochemistry of the chocolate, but it would also allow me to taste the chocolate.

Three years later, I found myself shadowing a seasoned pediatrician. It was a Friday afternoon, the last patient of the day, but he still talked to the patient and his mother like time did not exist.

The mother asked, “So, my sister recently had that stomach surgery, and she has lost a whole lot of weight— now what about that?” The pediatrician flipped over the growth chart he had been showing them and began to make a crude sketch of the stomach and intestines. He began to describe.

“The surgeon will remove this portion, and then reattach this portion of the intestine to the stomach.” All the while the mother and child looked on intensely, nodding occasionally. Were we in a patient exam room with a pediatrician, or had we somehow traveled into a grade-school classroom with a veteran teacher? The “students” were eagerly hanging on to every word the teacher said; they were intently watching as he pointed to each part of the drawing. For these students, this was one of the most important lessons.

“Without healthy lifestyle changes, John’s hyperinsulinemia will progress into Type II diabetes soon. A procedure such as this one, however, comes with many inherent risks as well,” explained the pediatrician. The mom’s facial expression transitioned from one of perplexing concern to one of realization.

“We will work on these goals from today, Doc. Walking for 20 minutes three times a week, and no more sugar-sweetened beverages. We can do that, John.”

A few years, later I started medical school, and my perspective continued changing. We began to learn how to interview patients, many of whom were much older than me. These patients had traveled the world, they had experienced life, and they were sharing their experiences with us. I met free-lance writers, professors who had studied at such prestigious universities as Oxford before becoming cruise line lecturers, high school teachers, and promising students. Then we began anatomy. The first day of lab, we all awkwardly changed into our scrubs and lab coats. Questions ran through our heads. Do our scrubs fit right? Should we tuck our shirts in? How bad is the smell of formaldehyde? Will we be able to handle the dissections? We were working with chilled, lifeless bodies, and most of the time we could focus on our work without hesitation. The glimpses of painted fingernails or remaining equipment from life-sustaining efforts reminded us of the lives these patients once lived. These people had families, pets, and even hobbies. We had experienced our first patients.

Later, during clinical week, a young girl with bright eyes and parted lips, almost as though she had a question, looked at my preceptor and I.

“Hello, Susie, I am Dr. Jackson and this is a medical student who is here with me today. Guess what? You get to be her teacher for the day. She gets to learn from you,” my preceptor said with a friendly smile. I had not considered this. I thought I was going to be the teacher, as a young doctor-in-training.

You see, as physicians, we spend many years engrossed in the technical details of how the human body works and what happens when people become sick. All the while, the world goes on, people are out living, they are out tasting the chocolate. The advantage as a doctor, however, is the opportunity I have to spend the rest of my career tasting the chocolate with them. I will teach people many things about how their bodies work, and why they feel the way they do. All the while, every single patient will teach me something too. They might have an interesting profession I have never heard of; they might have just retired from a cruise line after being a lecturer for 56 cruises. Unfortunately, sometimes my patients may not make it, but even then they will teach me. The ones I cannot save will remind me to be humble, they will remind me of my humanity, and they will remind me of how short life can be.

Every afternoon of shadowing the seasoned pediatrician ended with a question: “What did you learn today?” So now, I ask you, who is the teacher? Are we the teachers as physicians, explaining the complexities and inner-workings of the body, or is society, our patients, the teacher as they teach us about more life than any one person can live?