The know-it-all that’s always wrong
— Ab-Soul
Ideally, the best teacher should steer you to greatness.
They will not always be with you, holding your hand, but they will light the way. It is your job to place one foot in front of the other. Even then, the light from the torch they hold will only go so far. Having already started the trek, should the light go out, you may not have as much incentive to go back. A good teacher is as good as a nudge forward, in the dark, confident that you will make a way where there seems to be none.
The ideals of what a teacher may be will always echo throughout history. Some key qualities, however, stand out for me. Passion is one of them. An animated teacher is not an actor. They are driven by love for the subject. In contrast, my first honest teacher was not animated. We’ll get to that in a while.
The caring teacher offers themselves to the subject. They are willing to learn as much as they teach. They acknowledge that they may not know it all, but they are willing to learn. As Ab-Soul raps, they’ve got to do better. They do better.
My favourite teachers, in retrospect, were always dead. From the other side, they would share their best ideas most coherently through books. Karl Popper was the very first true teacher. I have yet to voraciously consume heavy books by an author in a short time as I have by Popper. As he once told me, however, anyone could write a book to drive their malicious agenda. It is not always guided by truth. Books are fantastic teachers, but they are not always honest.
A caring teacher will not show you where to go. They can tell you where not to. The future is left open for the student to craft their way. Or as Ab-Soul raps:
Reach for the galaxy
Leave stardust for those after me
Enter the void, fill in the cavity
Risk the reward if that’s how it has to be
So one Wednesday afternoon, while headed to the gross anatomy lab, I met my first honest teacher.
Some fainted after the first encounter
You never think the dead will teach you in more ways than one. Books do this marvelously, but the authors do not tend to give themselves wholly into a single work. A human body does. My first encounter with the honest teacher was after meeting the cadaver.
Teeming with excitement, we called her Wednesday. Rather, I called her Wednesday. My table members were reluctant to give her a name. I couldn’t let the opportunity pass. We had a few female cadavers in the lab. We had to give her a name. Wednesday was my first honest teacher.
She gave her all, literally, to teaching a wave of new potential doctors. From her sacrifice, I learned how to hold a scalpel. I fell in love with the course of vessels. I discovered how easy it is to think a fascial strip could be a nerve. I knew how easy it was to get variants different from the expected normal drawings in Netter’s Atlas of Anatomy. Because of Wednesday, I was chosen to pursue an intercalated degree course in 8 months and learned even more about human and developmental anatomy than I ever thought I would.
While I beamed at the chance to interact with her, others fainted. The sight of a cadaver is not for the faint-hearted. Another fraction opted not to consume beef for weeks. A small portion quit medical school altogether. While my good friend, Oliver Kiaye, called his cadaver his first patient, I called her Wednesday, my first honest teacher.
How do you get a teacher who does not flinch when you dig deep into their tissues? Open in every sense of the word? Given their lives in physical form, unto death? That is the true mark of an honest teacher.
Notable in a cadaver is the willingness to answer all the hidden questions an inquisitive mind harbours. They validate hypotheses one may have. If you think a structure is a nerve, you can test it with your friend, your colleague, online literature, or develop something new. Unfortunately, like most great teachers, they get forgotten by history. Their students, on the other hand, are remembered.
This was how I discovered that there is another group of honest teachers I encounter more regularly.
At work
Wear the crown of thorns for sport, I’m just waitin’ for a stone to hit me
— Ab-Soul
When I tell my students that I love working in the ICU, they always think it is because the patients hardly ever speak to us. This morbid knee-jerk response implies that I like my silence and peace. No doubt, I do. But implicit in this suggestion is that everyone who walks into our unit has a single path, a one-way valve to death.
Quite the contrary, I love it when patients recover. Before they do, however, they face some of the biggest battles. Picture a patient with plastic tubes sticking inside their mouth, neck, arms, and legs, unable to speak but fully awake. They lie with their thoughts, with no rectangular screens to scroll.
The other patients are not aware of their surroundings. Fully sedated, they have every other clinician trying their best to save their lives. It is this group of patients that I would also label as honest teachers.
Unlike cadavers, patients are a chance for the clinician to test if they understand how the human body operates. For the most part, we don’t have the best medicine. We always try to improve our knowledge, but it will always fall short. In one case, a patient survives a cardiac resuscitation, following an internationally accepted protocol. In another, they die.
That too is a blank statement about our ignorance. We may have the most updated guidelines, but that is as far as they go. They are lines that guide.
Often, I surmise how easy fingers get pointed at anyone who thinks a doctor was inconsiderate because they didn’t follow the guidelines. The evidence lies in the words — lines that guide. A doctor is someone who has studied rigorously to pass their exams. They continue to study to understand the human body in its worst form, then squeeze it back into the curve of normal distribution. A guideline will only guide. A question we need to ask ourselves is how the guidelines were formed. It is through bold action.
Often, doctors have their reputation at stake when they try new ideas, suggestions previously never considered to cure certain conditions. Drug discovery is a journey in trial and error. And the doctor, facing a patient who is intubated, on pressure, ventilatory, and kidney support, faces yet another honest teacher. Developing new ideas is akin to putting your reputation on the line.
Dr. Min Chiu Li used a single marker, beta hcg, to gauge whether the cancer he was treating, choriocarcinoma, was completely eliminated. The guiding principle was that once the levels were below a certain threshold, patients could be categorized as being in remission. He wasn’t having any of that.
Every time his team ran the test, some traces of the hormone showed. So he continued giving the patient the drug until finally, the test came back negative.
He was fired.
Later on, it was discovered that that was the ideal way to handle such patients. By being bold, he was vindicated.
In the ICU, we get a chance to learn from honest teachers, and we have to sometimes entertain ideas we may otherwise not have a chance to test. These are the loved ones of a family somewhere. These families may say we try everything we can to save the patient, but scientific grounds limit us. As much as the honest teachers reveal our degree of ignorance, we may not have the full armoury to investigate just how far our solutions may go.
The highest rank of evidence, randomized clinical trials with meta-analysis, hardly accounts for a single patient. This is perhaps the widest gulf we have against diseases. That is, we need large numbers with a trial intervention to validate its efficacy, but when treating a patient, you work with a single one; an honest teacher, but one who we may never get a chance to learn from.
Post-mortems are also limiting. A living human offers a real-time test. Cancer management has progressed this far because of these tests. Victims sign up for novel treatments, hoping an olive branch stems from the intervention. We saw the outcomes during the COVID-19 pandemic. The result was RNA vaccines.
It begs the question: How far can a student go when granted an honest teacher in a world governed by ethics, laws, customs, and traditions?
What I’m trying to say is…
Well, to answer that question is to admit that we still haven’t found a solid middle ground for postponing or cheating death. Restrictions bar clinicians from exploring wild ideas, but caught in the same net are honest workers who would have developed scalable solutions for different illnesses. Ab-Soul says that we have to do better.
The saying goes that when the student is ready, the teacher will present themselves. But what happens when the student is barred, ethically, from learning?
We already have honest teachers and students. From there, how do we do better?
This song inspired some of the lines used in this article. Source — YouTube