I grieve the loss of Sir Roger Bannister, whom I never got to repay for his kindness to me. But at least let me relate my favorite story about the great man.
Many people don’t realize that his achievements didn’t end after his famous athletic feat. He went on to become a prominent and respected neurologist who mentored a number of my London-based colleagues. One of them was training in internal medicine and Sir Roger was teaching a mini-rotation on neurology. She was struggling and he had to give her some feedback.
He: “You simply spend too long with each patient. You will never have as much time in everyday practice as you spent with that head injury case this morning. Just make an quick initial assessment and refer the patient on to neurology if you suspect serious damage.”
She: “I needed the 30 minutes to be sure.”
He: “In practice, you will have to do at least 15 of these screenings in an hour.”
She (getting irritated): “I can’t do a neurological screening in just 4 minutes!”
He (with a kind smile): “You might be surprised what you can accomplish in 4 minutes.”
When I click through to your post about his kindness, I get an error that I cannot preview drafts. Is it possible you have not yet clicked publish on that post?
Thanks for catching that. Not sure what happened but I have repasted the link and now it works.
Now THAT's a humblebrag!
Well, I don't know about lightning examinations. But there is a ten second mental status exam that goes like this. You tell the patient to interpret a proverb: "Once a king, always a king, but once a knight is not enough." A normal response is laughter. You can then move on to the rest of the examination.
And of course, some of the other bog-standard mental status exams have significant situational variations — I think it was Lancet that did a piece on how long it took otherwise-competent people to keep up with changes of prime minister, president or even year.
Cute, but was Bannister addressing the issue? Can a doctor do an adequate neurological screening in four minutes?
I think the issue of the person training in internal medicine was that she had an unrealistic expectation for herself: "I'm a doctor, so I have to learn to do a really good neurological screening."
Dr. Bannister's advice was "do a quick assessment to decide whether you think this patient needs a really good neurological screening. If you think so, don't waste your time trying to do it. For one thing, you'll take far longer than an expert would. And for another, you're not an expert, so your conclusions will need to be confirmed by an expert anyway. So recognize that in the field of neurology, you're just the gatekeeper. Open the gate and let the patient in."
Yeah, it sounded like "learn to triage, young Jedi". Good advice.
Great anecdote…I posted it at Track and Field News…hope you don't mind…
https://trackandfieldnews.com/discussion/showthre…