I'm Not That Smart

"I'm not smart enough to know what this man has, but I am smart enough to know when I need help." (Steadism #341, p92)

There is no way in this world that any one person can know everything there is to know, off the top of his/her head, in all situations encountered in the practice of medicine. So why is there this culture of memorization in the face of evidenced-based practice, technology assistance, and a knowledge base that seems to be growing before my very eyes? I am regularly, daily, moment-by-moment amazed at what I don't know, what I have forgotten and what I will likely never know. I've had at least 5 "eureka" experiences today...realizing what I didn't know when I was actually practicing the craft and muttering to myself, "ohhhhh that's why that was [such and such]." I get that we are supposed to have a grasp of the concepts and become facile with and in the terminology, but in the words of one of our 4th term colleagues (getting ready to start rotations), "I barely remember what day it is..."

I think the goal of this process is to find a niche...a practice, with a collection of patients, in an area, that you can remember enough to not hurt someone, and still fool the majority of the lawyers that you remember everything...knowing good and well that you can't remember everything and might hurt someone if you aren't diligent about your practice and refer when you are smart enough to know when you don't know what you don't know. Whew! Then of course, the referral will have to be approved by a reviewer at an insurance company that is trying to pull off the same. I may have to Google that to be sure.