We Have No Beds

There are many simple aspects of public hospital medicine that are only learnt by experience and become invaluable. They are sometimes taught but more often, they just seem to happen over time. For too long now, perhaps this most important part of any resident’s training has been ignored. Medical students have been instructed in basic sciences at university. Similarly, medical and surgical teaching was completed in the public hospital system. Following are, internship, residency and, perhaps, consultancy, with training in the traditional accepted manner. But all this only indirectly teaches us the true art of public medicine. Any resident who has been around for a while has a certain sixth sense, of which he/she may or may not be aware. (Unlike the movie, they say ‘I don’t see dead people – in fact, I don’t see many people!’) It is a very difficult thing to explain. Some never get it; all ‘proper’ registrars exude it. They shun unnecessary information, patients and thereby, work. They retain only what is needed and useful, and apply it in ways that spellbound the tyro. I remember often watching my registrar in awe, and soon learnt to note down his quiet advice. Here is some of that advice.