15th July 03:23
The anatomy of incompetence - W. C. Douglass II, (crisis job)
The anatomy of incompetence
Ever since just after the Middle Ages, when cutting open the human
body after death was forbidden (even if being hacked open had been
the CAUSE of death), the standard method of educating doctors — and
what passed for them in the old days — in basic anatomy has been the
dissection of cadavers. But nowadays, the cadaver and all the
anatomical education it represents is slowly disappearing from
Medical School curricula.
Hmmm. Doctors without first-hand knowledge of the human body. Now
there's a good idea!
Yet according to a recent New York Times article, even the President
of the American Association of Clinical Anatomists is today uncertain
as to whether or not every medical student needs intensive lessons in
gross anatomy. There are even medical schools out there (in
California, of course) that teach anatomy without ANY hands-on
contact with a body, living or otherwise.
Proponents of the new corpse-less curriculum point out that much of
traditional anatomy training — the litany of Latin names for every
pathway of every nerve and blood vessel, and things like that — is
irrelevant to current medical practice, which increasingly focuses on
treatment at the cellular and genetic level (read: drug- based). Plus,
they claim that new, high-tech computer models and virtual reality
software do a better job of teaching the body's structures than
actually touching them…
But beyond the simple identification of bodily parts, where they are,
and what they look like in their normal states, hands-on education
teaches doctors the fundamental skill of their trade: What it FEELS
like to heal. How can a video screen teach what it feels like to set
a broken bone back into place? How can a software program truly
impart the art of finding an artery to test a pulse or a vein to draw
blood from? How can a thing without a face or flesh teach the
reverence for life all doctors must have to be anything more than
Did you know that in many Latin American countries students go from
high school directly into medical school, which means they have no
basic training in the sciences except the pitifully little they learn
in high school? If they follow our lead — and they always do — they
will be even less qualified than they are now.
Of all the old maxims, the cardinal one is this: The best way to
learn is by doing. That goes for doctors, more than anyone. Would you
want to be treated for a femoral fracture by an M.D. who'd never seen
one up close, or felt the way it was put together as original
Yes, doctors using real human bodies for practice may be going the
way of the dinosaur. What will they be replaced with (besides video
The new game of "Operation!"
Almost as absurd as med school students not practicing on cadavers is
the idea that they won't need to hone their skills on the living,
either. Yet that's exactly what the future holds, if the latest in
virtual reality educational technology is any indication.
According to CBS News.com, many new doctors these days are making
their first diagnoses not on live patients while a seasoned M.D.
looks over their shoulder, but on life-sized electronic replicas
complete with hair, skin, moving eyes, and inject-able veins! The
dummies can be programmed to breathe, react to stimuli — even
simulate every imaginable medical crisis to challenge new doctors'
diagnosis and treatment skills.
It's like the kid's game (Operation!), but on a bigger scale.
Barely 10 years old, this kind of technology has already been adopted
by over 120 medical schools nationwide, and has been aggressively
implemented by the U.S. military (where I cut my teeth in medicine).
Apparently, these "smart" dummies are the future of medical training.
Some seemingly credible sources cited in the story claim that these
"mannequins" are far BETTER for medical training than real live
But I have trouble believing it. Maybe I'm old fashioned, but I think
the skills a doctor learns from the living are some of the most
important ones — and they aren't found in textbooks or in the eyes of
souped-up CPR dummies. Things like bedside manner, intuition, and
listening skills come to mind.
These plastic patients are no doubt good for one thing, though:
Rendering harmless the potentially lethal mistakes-in-training made
by surgeons who don't know their anatomy.
Always hands-on, but never a dummy,
William Campbell Douglass II, MD