Children teach a trainee

I had a an unusual interactive evening with some paediatricians and trainees recently. It was an open forum when they decided to ask me questions on my life, learning, hobbies, experience, etc. 

One question which they asked me on my 'way of learning child health ' made me think and recall my learning process. 

From the very early days of my training in the late nineteen seventies, I had teachers, who loved children and spent hours observing children and their play, behaviour, communication and physical signs. A morning round would not even finish by 4 pm as my teachers gave considerable importance to use clinical skills to make diagnosis and plan treatment. 

One night when I was on call duty, I had a child of nine months who was incessantly crying and could not be consoled. At 11 pm I called my consultant on phone, who asked me bring the child to the phone so that she could hear the cry of the child.  After listening to the cry of the child for about ten seconds, she suggested that the infant may be in pain and asked me to look at the ear drum for any signs of otitis media. Lo and behold, one ear drum was bulging. 

My training was largely guided by some broad principles of learning: listen to parents, observe children; consult seniors to develop skills in diagnosis and treatment,   read  from books and discuss with colleagues  for reinforcement of learning. Somehow this gave a good foundation to be clinically comfortable. Although this consumed a lot of time, it grounded me in some good clinical practices.

Another professor used to say, that 'every post graduate trainee need to examine at least hundred children to pick up neurological skills and auscultate five hundred children to be sound in clinical cardiology'. 

A third professor's emphasis was to create in us the art of communication with children and parents. He would tolerate a bloody lumbar puncture tap but not our failure to explain the procedure to a child who could understand. He watched us to see whether we would explain the procedure to a child before an injection was given or veni-puncture  done.  

I enjoined my training, although I was on call on alternate days during the training period, because our teachers enlarged our understanding in novel ways. Our teachers often told us, 'children are our teachers in clinical paediatrics'.

M.C.Mathew(text and photo)