“There is no more difficult art to
acquire than the art of observation”, said Sir William Osler many years ago.
And despite the leaps in medical science and technology, it is as true today as
it was then. Dr. HPK illustrated this beautifully this week when he related to
us several stories about former patients whose diagnoses were clinched based
purely on the observation of the patients’ appearance, signs, and symptoms.
Diagnoses ranged from aseptic endocarditis to thyroid storm and polyarteritis
nodosa. Dr. HPK explained that the basis of his diagnostic acumen is careful
observation and use of all senses – sight, smell, touch, and listening – which
can often provide information critical for making a diagnosis. It seems that
with the advent of blood tests and imaging studies at the snap of a finger,
there is a declining use of inspection as part of the physical exam. As Dr.
HPK’s cases demonstrated, weeks of diagnostic tests that failed to yield a
diagnosis, could have been avoided had the art of observation played a more
prominent role in the process.
As I wrap up this rotation, I think one
of the most important things I will take with me is that although the way
medicine is taught may have changed and evolved over the years, the art of
observation remains vital.
And because I can’t resist quoting the master
again:
“The whole art of medicine is in
observation… but to educate the eye to see, the ear to hear and the finger to
feel takes time, and to make a beginning, to start a man on the right path, is
all that you can do.” – Sir William Osler
As this will be my last post, I want to
thank Dr. HPK and Dr. RC for the great experiences I have had in this
Selective!
-Laura
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