Several years ago, when I needed a minor operation, I asked my brother-in-law, a hematologist, for the lowdown on my surgeon. “What were his hands like,” he demanded, after my first consultation. “Did they shake?”
My brother-in-law was joking, but his comment made me realize that a firm handshake and a steady eye are as important as gold medal grades. Patients have enough to fret about before an operation or a tricky procedure without worrying if their doctor honed his hand-eye co-ordination playing video games. The good news is that teaching hospitals like Sunnybrook have ultra-expensive and high-tech simulation centres where medical students can practise their suturing and cutting skills on robots instead of people.
The practice rounds include delivering babies in breech position, intubating elderly patients and replacing heart valves. Watching the students work in competing teams is like the medical equivalent of a television reality show – except that the stakes are potentially much higher than winning a million dollars.
Even something as seemingly simple as post-operative pain management can be harrowing as the team tries to respond to a moaning patient who quickly develops breathing problems. Upping her pain medication and watching her blood pressure plummet and soar like a runaway roller coaster is a terrifying lesson in cause and effect. Should they call for a cardiac consultation in the middle of the night and risk the ire of a sleep-deprived resident, or keep pushing drugs in hopes that the patient will stabilize?
Behind the scenes, Susan de Sousa and Agnes Ryzynski, the simulation centre co-ordinators manipulate the patient’s vital signs and throw medical curves to put the students through their paces.
These students, who don’t look old enough to drive by themselves, are breathtakingly smart, but that doesn’t mean they have the experience, the confidence or the skills to work together effectively as a team, especially when the pressure is cranked up in a scenario that began with a patient calling for an analgesic and may be heading for a cardiac arrest.
Fortunately, the patient rarely dies. The object is a teachable moment, not a trauma that might haunt an aspiring doctor. As for me, I am delighted to watch them practise on a doll, albeit one that has a pulse, rather than a real patient. Been there, thanks.