December 27, 2008

Inspired by Pixar

My two favorite companies are Google and Pixar. They have an amazing group of individuals with energy, passion and creativity that allows them to do things that have never been done before! I think it's absolutely incredible... and perhaps in another life, I would have loved to work for them in some fashion or another.

From watching a lot of special features from Ratatouille and Wall-E, I pondered a lot about the cultivation of the "culture" that Pixar has created for itself. Of course, the playful fun and games environment makes them LOVE working and so, they are all dedicated to seeing a project through to its completion. It is the sort of place that I'd like to work at... but really, can that exist in a hospital or a clinic in any form?

I am reminded of what one of my interviewers said to me. He inquired about my hobbies, my loves and I told him about my enthusiasm for the game of Dungeons and Dragons. How this alternate reality has given me a freedom to explore and understand characters... feel young with my imagination. "Don't lose that," he told me. "Hold onto that when you become a doctor." I guess I could have a pediatrics exam room decorated with anatomy of dragons and old posters of alchemical potions or something. :)

In all honesty though, it really gave me pause, trying to think of how my future profession utilizes creativity in an everyday sort of a sense. After all, a lot of what I spend my days doing is learning facts and understanding evidence, with the ultimate intent of practicing the best medicine possible. What room does that grant me? I can't be wild and crazy with my application of antibiotics in the treatment of cellulitis. I can't come up with some genius new technique for stitching up an incision.

Then, it hit me.

The art of medicine... that elusive thing that I realize each and every time I sit down with a patient, I really don't know anything at all. The art comes from a few things.

Elicitation - Asking the right questions to create a differential and swiftly narrow it down to a convincing diagnosis.
Elucidation - Clarifying the complaints and concerns of the patient.
Inspiration - Recognizing moments of connection and acknowledging them, chasing down a clue that a patient may have only hinted at by a small gesture, snapping on an excellent diagnosis and proper management
Exclamation - Conveying a diagnosis and educating the patient on his/her role in its management

and that's just the doctor-patient relationship. there's the nurse-doctor relationship, the insurance-doctor relationship, the wife-of-doctor relationship things that must be managed with as much care as the dr-pt.

This "art of medicine" may not have the same sort of creative energy that an "art of animated movie" has... but I'd argue that it's much more important, because its so fundamental.