“So, the next step in the history taking process is to define the pain. You start this by asking for site, with questions like, “Where are you experiencing the pain? Can you pinpoint the site or is it more general? Does the pain radiate (spread anywhere)?” And if the pain is on one side of the body, remember to ask about the other side – this is important. Got it? Okay, the next step is severity…”

As the tutor speaks, the flurry of medical students typing notes is oddly reminiscent of a waterfall, with myself and 11 other first year medical students taking part in its creation. The class I’m in is called Clinical Skills Tutorial (CST), which teaches the more practical skills of medicine such as taking histories or doing patient examinations – this week, we are being introduced to the history taking process. But while it is exciting to learn what a doctor does, I can’t help but feel a different, uninspiring feeling rise up within me as I type. A twinge of… disappointment. The disappointment initially surprises me but after a while, it fades away. I soon realise why.  

When I was little, I thought doctors were a special breed of people – those blessed with levels of intellect, observation and analytical thinking far beyond that of the general population. A ‘superhuman’, if you’d like. I always marvelled how a GP, upon never seeing a patient before, could diagnose the cause of chest pain using a few questions, tests and some poking around and then prescribe the perfect drug, where the patient would then live happily ever after (hooray!). I imagined doctors had flashes of superhuman genius which told them what questions to ask, what diagnoses to make and what decisions to make in critical situations – a process mere humans could never understand.

But of course, doctors are human and have limitations like the rest of us. Doctors often get things wrong, with diagnostic error rates estimated to be close to an alarming 15% [1]. And from my first few weeks of medical school, it seems unlikely that wild ‘flashes of inspiration’ occur at all. Rather, medicine seems more mundane, more formulaic – a process of extracting the same pieces of information from each patient and recognising particular groups of symptoms. Almost like pattern recognition, like a game. Nothing too superhuman at all.

It’s somewhat disappointing to reach the conclusion that doctors probably aren’t too different from the rest of the population. I imagine the notion of the ‘superhuman doctor’ is something we hold for our own sake – we want doctors to be infallible, incapable of getting our diagnoses wrong, when in fact doctors can get sick, miss their families and become exhausted just like the rest of us. Despite all this, the ordinary doctor tries their best to repair a patient, knowing full well that they share the same limitations of energy, time and need for social connection.

But perhaps it is exactly this that makes doctors and other allied health workers superhuman: the constant exertion of effort to reach an unattainable level of perfection for the sake of the poor, the injured and the broken. It’s taking potential burnout, imposter syndrome and unmet social commitments and temporarily moving them aside to make space for the patient’s needs. Caring: perhaps this is what makes healthcare workers superhuman – not some transcendence of IQ or memory, but something more subtle, more internal: the prioritisation of others’ needs above your own. Now that is pretty extraordinary.

Sources:
1. Graber ML. The incidence of diagnostic error in medicine. BMJ Quality and Safety. 2013 Oct; 22(Suppl 2): ii21-ii27.