Knowledge is a Network, Not a Tree#
About half a year ago, I self-studied skull base anatomy in the otolaryngology department. At that time, I had no idea how it would be useful. The main reason was that I found it interesting, curious, and challenging (skull base anatomy is widely recognized as difficult). Of course, there was also the direct reason that the teacher assigned the topic and I didn't want to change it (Teacher: "You're in orthopedics, so why don't you teach us about skull base anatomy?")
In order to teach it well, I watched almost all the related videos on Bilibili. Later, I spent a whole night making slides using anatomical atlases. The result was very good. First, I understood it myself at the time, and secondly, the tutorial I recorded helped many people. Even now, half a year later and having forgotten everything, I can understand it again by watching it. However, at that time, I still felt a bit uncomfortable: Was it worth spending so much time learning something seemingly unrelated to orthopedics (which generally doesn't involve the skull) and traditional Chinese medicine? Why didn't I study something more important, like the content of the physician licensing exam?
Recently, I happened to encounter a case of a craniopharyngioma (a brain tumor that grows near the sella turcica) in neurosurgery. I was able to apply the relevant knowledge, such as the structures near the sella turcica and the tissues that the transcranial approach would pass through. Suddenly, I felt that the effort I put into studying was not wasted. It was actually useful. I also thought about all the seemingly useless efforts I had put in before, such as non-steroidal anti-inflammatory drugs and right heart failure. Every time, I started from scratch, consulting numerous videos, books, and papers, all to improve my knowledge framework.
Medical knowledge is not categorized like books, with branches and leaves like plant stems. It is more like a spider's web. Today, I illuminate one piece of knowledge, and tomorrow, another. One after another, they connect to form a large web. The larger the web, the easier it is to connect new knowledge with existing ones, and the faster we learn.
If I hadn't previously studied skull base anatomy in otolaryngology and brain anatomy in neurology, I would definitely have to start from those two subjects when learning about craniopharyngioma. Otherwise, I wouldn't understand the positions of structures such as the sella turcica, pituitary gland, and optic nerve, and I wouldn't be able to comprehend the pathogenesis and clinical manifestations of craniopharyngioma. I would also struggle to keep up with the surgical treatment plan.
Dare to Be Different#
I used to think that as long as a person wants to do something, they can achieve it. Recently, I have increasingly felt the importance of the environment. When everyone is studying, I am likely to study along with them. And when others are slacking off, I am likely to do the same. I realized that one of the main reasons for this is the fear of being different.
Recently, during my rotation in pediatrics, almost all my classmates were playing with their phones. Some were preparing for exams, and hardly anyone was participating in pediatric clinical practice (outpatient visits, tuina massage). At first, I also played with my phone, but it didn't feel right. On one hand, I didn't have much to do on my phone, and on the other hand, I felt anxious. I felt that since I was in pediatrics, it would be a waste of opportunity if I didn't learn something.
Later, I started actively listening to the teacher's patient interviews. If there weren't many people, I would directly take over the interviews for the teacher. I saw all kinds of patients, and my mind was filled with more and more questions. Whenever I had free time, I would ask the teacher, and I would always receive patient and meticulous answers. I gained a lot of clinical experience, such as:
- Children can develop kidney stones from excessive intravenous fluid administration, which can cause abdominal pain because ceftriaxone can easily form polymers with urine and bile.
- It's best not to remove adenoids/tonsils if they are hypertrophic. If they are removed, infections will bypass the nasopharynx and directly enter the lower respiratory tract.
I think if I hadn't asked these questions and the teacher hadn't answered them, I wouldn't have had good outcomes when facing these situations myself. When a child has a stomachache, I wouldn't have thought to ask if they had received a lot of intravenous fluids before or if their tonsils were severely enlarged and should be removed.
When everyone is going left, knowing what you want and igniting your passion, dare to be different!