Spending time as a junior during ward rounds, Samer described how he would regularly encounter consultant surgeons approaching a sick patient, who was ignored while the surgeon expounded his diagnosis based, not on the real symptoms as expressed by the patient, but according to the latest paper that he (usually male) had read on the subject. Samer became concerned, as his own discussions with patients often showed that they had no clue as to what was happening to them. He developed approaches that were based on the dialogue with the patient. In 1995, he led a group which developed the EuroSCORE system –a safety and monitoring tool which predicts the outcomes of heart surgery by analysing the risk factors presented by individual patients. He’s also written a book called The Naked Surgeon, written to demystify surgery. Surgery, to him, is a people activity, not a paper one.
This was the point which I caught and reflected on, as the teaching profession is seemingly bombarded with prescriptions from all sides, not least from “Doctors” Gibb and Morgan. There is an almost daily diet of what’s “right for all children”, which often means doing exactly the same for longer, if the children don’t “get it” the first time. It almost seems irrelevant that a child might have specific needs which require an adaptation to practice, more is better. Doctors prescribe drugs to a patient, on the basis of the patient descriptor of symptoms. It makes both the patient and the doctor happy that they have done something. On occasion the drugs have side effects, at which point it can be the case that another drug is prescribed to counter the side effects. This approach, with a doctor seeking to mollify an anxious relative, led to a sudden collapse, which, on exploration, was caused by the cocktail of drugs.
Diagnosis and prescription need to be nuanced. Much effort is currently being put into personalising drugs to combat cancer.
In the same way, the diagnosis and prescription of educational need also needs to be nuanced, with the practitioner able to select from the available remedies the appropriate one for the need. This nuance requires teachers with the ability to explore inconsistencies in symptoms in a way that supports their diagnosis and to have available a range of remedies that can be put in place in timely fashion.
Doctors and surgeons don’t regularly see well people, only those with symptoms of ill health. In the same way, the majority of learners, given a healthy diet, careful nurturing and positive reinforcement, don’t cause the teacher too many problems.
We need doctors and teachers to be attentive listeners and watchers, to pick up the signs of poor health and development, not just to be able to quote the latest research paper.
Talk with children, they are the experts on themselves, at least as far as trying to explain their symptoms.