Atypical Med Blog

What does it mean to be 'a good doctor'? In my opinion, it means going beyond - beyond textbook knowledge, beyond protocol, beyond what merely needs to be done. Being a doctor requires intellect, clinical dexterity, decisiveness, integrity, and all the other virtues that give a person the honor of being responsible for a fellow human being's life - but is that the definition of 'a good doctor'?

To me, it is understanding that every patient is a unique person that is usually terrified and confused and requires more than just medical treatment. For most of a doctors career, they have been taught to hone their IQ, but not their EQ which in reality is equally important.

The 4 pillars of medical ethics (autonomy, beneficence, non-maleficence, and justice) and the Hippocratic are probably the best embodiments of the dedication and care a doctor must give to their patient, but it's really the application of these and the 'humane factor' that makes 'a good doctor'. I reckon what 'a good doctor' is, is subjective, but I say this based on what little anecdotal experience I've been lucky enough to have - shadowing cardiothoracic surgeons into the operating theatre (OT) and being present to watch the magic happen. Such experiences give more than medical knowledge, for they humble us and remind us that we're all human.

So, here's my "the experience that made me rethink everything" story.

It was 8 am and the OT was being readied for a triple bypass CABG (synonymous to the most exciting thing possible for an 18-year-old geek). The atmosphere was tense when the patient was wheeled in - a frail man of 60-something shivering as he stared around the room. He was genuinely terrified. Who wouldn't be? The anesthesiologist finished the insersion of the IV needle after which I asked the resident surgeon beside me if I was allowed to touch the patient (don't worry, I'd scrubbed) and he granted me permission. I stepped closer to the patient and held his hand firmly while the anesthesiologist told him he would be putting him under. He seemed to relax slightly after which he lost consciousness. The surgery that followed went smoothly - the grafts were perfect, they were anastomosed perfectly, his vital signs showed minimal fluctuations through the surgery. I left the hospital that evening feeling so grateful and accomplished - yes, the immensely talented surgeons did the hard bit and literally resupplied his heart with blood, but I did something tiny too. For the minute or so I comforted a scared man by holding his hand.

Reverting to the question of being 'a good doctor'? I'm just 18 and aspiring to one day save someone's life but this is my answer to the question. The smallest gesture could mean everything to a patient. What reaffirmed this thought was actually the inspiration for this blog - the medical drama "The Good Doctor" starring Dr. Shaun Murphy, an extraordinary young man on the spectrum with savant syndrome.

Shaun's visuospatial abilities, recall capacity, objective yes refreshing out of the box thinking, honesty, and adaptability showcase the potential he has to be a brilliant surgeon. That said, his bedside manner is sometimes inappropriate, to say the least, as he occasionally asks his patients offensive questions, logically arrives at the most statistically probable assumption and says it out loud, and also words any ideas for treatment prior to consulting his seniors. Still, we see how quickly (1 season to be precise) he earns the trust of his seniors and peers and blossoms into a remarkable surgical resident who's part of the team. People with autism are generally brutally honest and expect the same from others, thus are fundamentally very trusting. Seeing Shaun disrespected and taken advantage of by his peers is heartbreaking, but seeing his growth and perseverance is just that much more satisfying.

What truly resonates with viewers is perhaps his willingness to learn and his effort to communicate despite not being the best at it. This is underlined in an episode where he has a transgender patient with the genital organs of a male but identifies as a female. In denial at first and perplexed by this, Shaun repeatedly refers to the patient as "he", however, at the end of the episode we see him say "she's more of a purple girl" after just 1 conversation with her to fulfill his curiosity. In later episodes, we see him communicating with patients and peers in his own way, and even giving them advice based on anecdotal experience.

Being a part of Dr. Murphy's journey is gratifying because of the myriad perspectives highlighted - we watch our protagonist go from being defined by autism, to defining it as a part of him he's thankful for. Alongside his personal evolution, we see how patient care really goes beyond medical necessity and beyond the 'doctor - patient' formalities- to connect with people as humans who celebrate, laugh, and even cry together.

Best put by Dr. Glassman, one of my favorite characters and Shaun's number 1 advocate, father figure, and friend -

“Aren’t we judged by how we treat people? I don’t mean as doctors I mean as people. Especially those who don’t have the same advantages that we have. We hire Shaun and we give hope to those people with limitations that those limitations are not what they think they are. That they do have a shot. We hire Shaun and we make this hospital better for it. We hire Shaun, and we are better people for it.”

Porsche car, Prada bag, Pinot Noir wine – so much, of nothingness.

Not philosophically. Literally.

It is a humbling realization that we too are nothingness personified.

‘When you start to consider that atoms are about 99% empty space and they make up 100% of the universe, you can start to see: you're made up of nothingness.’ Author Trevor English reveals, ‘The entire human race, every single person, could all be compressed into a solid cube with the equivalent size of a sugar cube.’ Here’s how - atoms consist of nuclei, protons and neutrons centrally bundled together, and freely moving electrons; however, these subatomic particles are miniscule compared to the atom, therefore leaving a remnant of hollow vacuum.

‘Cut a grape in half, pop it in the microwave, and you’ll get a tiny fireball of electrons and electrically-charged atoms,’ and a whole lot of nothing.

The effects of a mostly-empty atomic structure are resoundingly shocking. Are you standing right now? Perhaps sitting? No – you’re actually floating, like a levitating monk.

The funky little particles called electrons carry a negative charge and exhibit what physicists call particle-wave duality. So, in practice, a negative electron recognizes fellow negative electrons from atoms around it, and moves at a scarily quick pace to place itself in the most conductive position for electromagnetic repulsion. This ensures you don’t ever touch anything, or anybody.

A few grim revelations, but don’t be disheartened.

If empty space were truly empty, atoms and therefore everything, would collapse. But here we are, how?

The problem arises when we think of an electron as a defined circle, rather than a dancing, undefined point source with wave function. To quote Researcher Lily Asquith, electrons ‘can be thought of as little clouds which have a dense foggy core and then misty edges, but that would be wrong because there are no edges. The mistiness goes on for ever, overlapping with every other misty cloud everywhere in the universe.’ So, electrons are everywhere. And nowhere.

Human touch is perceived when our anti-physical electrons cause a repulsive cascade of atoms to shift, build pressure, and eventually generate an electrical signal via propagating the rearrangement of ions at a nerve ending. Essentially, a change in charge causes our nerves to transmit signals to our brain and consciously register the sensation of touch.

Astrophysicist Professor Siegel says, ‘Inside your body, you aren't mostly empty space. You're mostly a series of electron clouds,’ a bubbling soup of quantum fluctuations, much like everything else that exists. And, while you can’t ever technically physically touch anyone, your energy is omnipresent.

Madonna sings, ‘We’re living in a material world,’ where it’s often easy to lose track of what is truly important. So, take a moment to appreciate the mysteries of the quantum world that make us everything and nothing, and give us energy that is infinite.

Breathe, and radiate all that is good and kind, for it’s likely to reverberate across the cosmos.

Touching, right?