Written by: Dr. Raymond Cruz
I was just reading Ronald Epstein’s book on medical communication entitled “Attending: Medicine, Mindfulness, and Humanity”. Dr. Epstein expounded on the lack of creative thinking among some physicians. He encourages everyone to remain curious in order to find innovative ways to treat patients. Epstein cited certain examples ranging from patients who were deemed to be difficult to talk with, to surgical cases where nobody was creative enough to point out to a surgeon that he was missing a cyanotic kidney during an operation, resulting in necrosis.
There is a tendency for medical consultants to stick to what works for them, when in fact there are other equally viable options.
When we were children, curiosity was a given. We would touch, hold, taste, and feel anything we can get our hands on. But as we grew, things happened. Societal norms engulfed our thinking, and we started to take into account the repercussions of our actions. We feared punishment or ridicule. We became conscious of disease - and so we got scared of experimenting with food! With the advent of social media, all our actions were magnified, and we became even more conscious of our actions, avoiding other people’s judgement. The gung-ho devil-may-care attitude we had as toddlers went away. Curiosity might be frowned upon, and we did not want to face its consequences.
What stifles creativity? First, an attitude of closed thinking destroys the creative process. Educational institutions tend to show only one answer to a medical problem, when in fact there are various treatment approaches available. Also, each patient is different, so it has to be a different approach for a different patient. There is a tendency for medical consultants to stick to what works for them, when in fact there are other equally viable options. One must be able to adapt to circumstances, because each patient is unique. A totally new and innovative therapeutic modality may be discovered by an inquisitive mind.
Another thing that stifles creativity is assessment. How someone is determined to be competent in the initial stages of learning could impact his or her actual performance later on. If we simply rely on objective examinations, we may be missing certain soft skills that are needed to make a difference. Medical training, however, has not perfected the art and science of assessing soft skills like empathy and kindness. Everybody loves a doctor with the ability to communicate without sounding too authoritarian, with an intellect that shows extensive experience and medical proficiency.
If Alexander Fleming had decided to clean out all his petri dishes, or if Marie Curie had dismissed the images she saw, we would not have discovered the mold that synthesized penicillin.
Fear definitely stifles creativity. There are studies suggesting that fear closes the mind to the myriad of possibilities. Those who are unafraid to tread uncharted waters eventually achieve breakthroughs. Remember that some of the greatest cures and diagnostic techniques were discovered by accident, such as the discovery of penicillin and the invention of the X-ray machine. If Alexander Fleming had decided to clean out all his petri dishes, or if Marie Curie had dismissed the images she saw, we would not have discovered the mold that synthesized penicillin. Nor would we have been able to see our insides to manage fractures and tumors.
Lastly, arrogance and indifference stifle creativity. When we feel that we know everything, we are longer open to learning new things. Being apathetic to what others are saying, instead of being open to suggestions, may also be to blame. And when we look into how our litigant attitude makes us afraid to make mistakes, we can see why defensive medicine has become the norm.
What the medical profession needs is a degree of openness that encourages out-of-the-box thinking to solve problems.
What the medical profession needs is a degree of openness that encourages out-of-the-box thinking to solve problems. The complexity of humans makes it imperative for doctors to learn to adapt to different situations and to be ready for unexpected symptoms or events. This is especially true at the end of life, when even the best technology can do nothing about the eventual course of nature. But the ability to communicate, to empathize, and to uphold human dignity inspite of the inevitability of death is an important skill that requires a fearless, frank, and open-minded physician. Medicine must be open to creative thinking during these instances. Clinical guidelines are important, because they regulate the proper practice of medicine. But where guidelines have no answer, the creative physician must take over. And to make a creative physician, we must foster an atmosphere of kindness, love, and understanding, not just pure intellectualism and academic bravado.