Tuesday, April 26, 2011

In Defense of Goofi(ness)

I've been wondering why young people seem to have the preponderance of good ideas and energetic enthusiasm. I think it's because they're naive, and some of them are goofy.

There's a first year resident on our medicine team who is constantly throwing out ideas about patient symptoms and findings. He's wrong more often than others on the team, and he's wrong in front of the attending.

He's publicly wrong, repeatedly. And he really doesn't care. He's a little goofy.

As may be expected, I've learned a ton being around him, far more than the tight-lipped who are right the few times they venture a conjecture. As may not be expected, everybody else, patients included, are better off. He stimulates thoughts, forces consideration of new ideas, and all that great stuff that people like to say is so important.

Best of all, his attitude is so non-prepossessing that others relax their wrong fear and likewise pose novel questions and ideas. Being goofy by definition means you're not trying to prove anything. In response, others aren't trying to prove anything back. In the absence of defending appearances, people think about patients.

You don't want your doctor to be a goof, and you don't want him or her to be naive. And for a large part, doctors-to-be are loathe to be perceived as such than pretty much anything else. Is there a way to improve this? Medicine is an understandably conservative field. But I don't think conservative has to come at the expense of stodginess.

My school has recently queried the students to see if the honors, high-pass, pass grading system should be abandoned for the third and fourth years. Absolutely.


Bryan Vartabedian said...

I'm old, naive and goofy. Fascinating post on a number of levels. Will ponder a post on this.

astupple said...

Thanks for the encouragement. For me, it gets to the point of the blog's title- there are all these close possibilities, and the naive and goofy have a better shot of finding them because they roam out there more readily.

I certainly wasn't intending to promote ageism!

Terry Kind, MD, MPH said...

Thanks for this post, stimulating thought and discussion, and critical thinking... is good. Some goofy pondering here as I wonder about a few things:

Wonder if the resident was goofy as a medical student too.

Wonder how things might be different on family-centered rounds ("goofy" in front of the family)

Wonder if the "absolutely" was how the students responded about abandoning H/HP/P or if that's how you respond, or both.

astupple said...

I think he was, it seems part of his nature.

His patient persona was more cheerful than goofy. The two seem to go together. Not sure what you mean by family centered rounds.

Absolutely is my reaction, which I sense is also true of the class as a whole.