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| COMMENTARY |
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| Year : 2021 | Volume
: 4
| Issue : 3 | Page : 76-77 |
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One pound of learning requires ten pounds of common sense to apply it
Arun Kumar Srivastava
Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| Date of Web Publication | 02-Nov-2021 |
Correspondence Address:
Dr. Arun Kumar Srivastava
Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IJNO.IJNO_412_21
How to cite this article:
Srivastava AK. One pound of learning requires ten pounds of common sense to apply it. Int J Neurooncol 2021;4, Suppl S1:76-7 |
The neurosurgical training program has changed drastically from the days of detailed history taking, clinical examination, making a differential diagnosis, followed by basic radiological help and ancillary surgical gadgets, to the so called clinico-radiological correlation and an “over” reliance on the modern surgical gadgets.
Moreover, we as teachers have added several protocols which somehow have curbed the liberty and time to think about many clinical issues and to react appropriately, considering time being a critical factor in neurosurgical outcomes.
This reminds me of a tale from the famous 'Akbar and Birbal' times. Once Akbar was forced by his wife to prefer her brother over Birbal. It happened that once while walking on the top of his fort, Akbar saw a hawker selling something. He asked his wife's brother to enquire what he selling. He immediately obeyed and ran down all the way and came back panting “Sugarcane, your honor”. “Is it sweet?” asked Akbar. He again rushed down and came back with an answer “Yes,”. This time, Akbar asked him again, 'What price is he asking? Very obediently, he went and came back in a jiffy,”One anna for 5 kg”. As a final nail in the coffin, Akbar asked him with an invisible smile on his face, “What if I purchase all his sugarcane”. He fainted and left. . Then came Birbal and Akbar started testing him in exactly the same way but Birbal enquired everything in one go. Obviously, satisfied the King. Akbar said to his Queen, “Birbal is no more intelligent than your brother, he is just using his common sense in a better way and that is making the difference”.
Neurosurgery, like any other specialty, is a rapidly evolving science. Protocols and methods of yester years are rapidly becoming irrelevant today but what remains, and similarly what we practice now, will most likely change completely in the near future. What will not change are honesty and common sense.
A perfect preparation of a scheduled operation can go in vain if we have not examined the operative site and some furuncle, ulcer or other skin lesion remains unnoticed. Rehearsing and discussing all the surgical steps and gadgets required during surgery and ensuring the availability of the latter, are no less important than the actual performance of surgery.
Going through the complete operation list for the day and not focusing only on one's own theatre is important to avoid last minute hassles like requirement of specific instrument, equipment etc., during surgery. One example is keeping an intraoperative cerebrospinal fluid (CSF) drainage set ready during cranial surgeries. It will come in handy during a crisis. It is not something that is told in advance every time, but we must anticipate and make it a habit, using our common sense.
As the common old Navajo proverb says, “Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime”. Once you try to emulate this learning experience on your own, you get to actually know the importance of common sense in practical life. We, as teachers, should encourage our students to imbibe this in their training period. What exactly is common sense? Sound and prudent judgement based on a simple perception of the situation or facts. Science is nothing but trained and organized common sense. Research findings have shown that knowledge, experience and common sense have a positive correlation with critical thinking of doctors.
While commanding four vessels sailing between England and India in 1601, Captain James Lancaster performed one of the greatest experiments in medical history. He made all passengers and crew in his ship sip three teaspoons of lemon juice per day. By the mid-point of the voyage, about forty percent of the sailors on the other three ships had died, the majority from scurvy, while none succumbed on his ship! This experiment is remembered less for its result, i.e., effectiveness of vitamin C rich citrus fruits to combat scurvy, than its aftermath. It took the British Navy perhaps a million deaths to adapt dietary regulations reflecting this simple, wondrous insight [1].
Technology and medicine have gone hand-in-hand for many years. In the present era, robotic surgeries, wireless brain sensors, bioprinters, etc., have undoubtedly improved the precision and outcomes of procedures. The reality, however, is that shortcomings, misinterpretations and resultant mishaps are also rampant in our execution of the same devices. Perhaps our faith in evidence based medicine (EBM) and technology as the “end all, be all” authority on best practice is so absolute and exclusive that it blinds us from our own experience and intelligence. It is thus imperative for a surgeon to interpret such techniques with a discerning eye and a healthy skepticism. Both our feet should be firmly grounded with our common sense and intelligence constantly at work.
| References | |  |
| 1. | Lind James (1965), Treatise of the Scurvy. In Lloyd, Christopher. The health of Seaman: Selection from the works of Dr. James Lind, Sir Gilbert Blance and Dr.Thomas Trotter.London: Navy Records Society  |
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