Medicine From The Trenches

Experiences from undergradute, graduate school, medical school, residency and beyond.

Teach Your Eye to See


In becoming a physician, one of the adjustments that must be made in medical training, is teaching your eye to “see” what needs to be seen. There is no medical test or radiographic imaging study that can replace what the human eye powered by the human brain can see and process by looking at a patient who comes into your care. It’s important to see the extraordinary in the ordinary.

One of my favorite exercises this time of year, is to find a point of observation in a crowded shopping mall and observe the shoppers. I look for musculoskeletal pathology in terms of gait abnormalities. I look at who uses those shopping scooters, usually young morbidly obese or elderly people. I look at how parents, children, friends and others interact as they hurry about their shopping. I allow my brain to observe as much as I can in the short period of time that people move past me.

I look at the complete environment of the mall such as the location of security cameras, the noise level, the composition of the floor as well as how many people can pass my observation point. I note the location and characteristics of security guards who are likely observing me as I observe shoppers.

The point of learning to observe is to allow your brain and eyes to focus in order to hone your observational skills. If you set the f number high on the lens of your camera, everything comes into focus. If you set the f number lower, the object in the center of your photo comes into focus but the background is blurred for emphasis on the intended object. This is often how one’s attention can be directed but as a physician, I have to look at everything, much like the higher f number.

Take everything into the context and get a complete picture first but then focus on what needs the most care. Learn to use all of your senses especially your vision and hearing as you put your patient’s story into context. Learn to see posture, gait, and overall affect as you interact with your patients. If family members are present, look at their interactions as well. In short, learn to see the whole picture, evaluate it and see the extraordinary in the ordinary.

In photographing the ordinary document clip on my desk, I see aspects of it that I don’t usually evaluate. I see the shadows along with the background as the clip rests upon it. Today, I never saw the small black dots as I think of my computer desk as only non-reflective gray. Today, as I look at my photo of one of many clips, I see something that I hadn’t noticed before. This is another exercise that I often engage in with my camera which is becoming an extension of my eye.

Along with visual observation, I attempt to hone my mental processing by using my daily morning distance runs to enhance my meditation skills. As I run along, generally after warm up, taking my attention from how my body moves, I allow my mind to go where it will. Thoughts enter and leave or stay with my like a song that I can’t get out of my head. This is a great reason to take 30 minutes each day to do something aerobic for your mind and body.

Along with training my eye to see beyond the ordinary, I strive to train my mind to consider all possibilities. The more possibilities I consider, the better my diagnosis. As my experience in medicine/surgery has increased, I want my mind to absorb as much of those experiences possible. Take some time over these holidays and observe, evaluate and enjoy the processing. Observation is a practiced and honed skill; good for any physician.


18 December, 2017 - Posted by | medical school, medicine |

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