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In my first year as an attending hospitalist, I personally discovered what Hippocrates realized millennia before, "Life is short and the art long." Clinical reasoning is an intellectual labyrinth that can only be mastered with deliberate practice, introspection, and perseverance.
However, I soon found that spending hours poring through manuscripts and cases was not only cumbersome but often counterproductive. It dawned on me then that athletes faced a similar predicament, one they handled in part by cross-training. Why then could I not use other activities to sharpen my clinical skills?
I am not a photographer by any stretch of the imagination, but since being exposed to the art in high school, I have come to appreciate the intricacies involved in taking a good picture. Over time, I have come to realize that many of the components required to capture a great photograph are also paramount in mastering a complicated clinical scenario.
Take the focus, for example. In photography, it is the key to the picture, the part of the image where our eyes are first drawn. A skilled photographer must visualize a scene and shift the camera's focus until their desired picture is captured. Similarly, a clinician must take volumes of clinical data and focus on certain parts to form a cohesive clinical image. For instance, a 35-year-old male presents with abdominal pain radiating to the back, nausea, vomiting, and a leukocytosis. The clinician who focuses primarily on the abdominal pain will go down a different path than the clinician who focuses primarily on the leukocytosis. Thus, an expert clinician, like an expert photographer, must be able to shift their focus until they find the clinical picture that is most probable.
Similarly, let us examine the zoom tool. A talented photographer knows when a scene is best captured up close or whether a broader view is preferred. An experienced clinician can also juggle between zooming in on the details versus taking a step back and assessing the big picture. Spending 30 minutes on counseling a 30-year-old with newly diagnosed diabetes on their diet could prove monumental. The same counseling in a 90-year-old diabetic with end-stage cancer likely indicates we are missing the forest for the trees.
And finally, my favorite tool, and the most nebulous of my analogies: the flash. For photographers, it is a way to light up a dark landscape. So how does this apply to clinicians? In a day and age where there are increasing administrative tasks, sky-high censuses, and burnout is ubiquitous, we must find ways to brighten the patient-provider interaction. For a clinician, the flash is the inner spark we bring to each clinical scenario. The human connection that transforms an encounter from being the 450th COPD exacerbation we have treated is an intimate opportunity for us to heal our patients.
In looking back, I find it somewhat revealing that Hippocrates quoted, "Life is short and the art long." Perhaps the father of medicine had also discovered the overlap between traditional forms of art and clinical medicine.
, is a hospital medicine fellow.
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