Simplicity : In Medicine and in Life

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“All I try to do is make it simple, the ones who make it complicated never get congratulated”

– Kid Cudi, from “Man on the Moon (The Anthem)

The first time that I heard Kid Cudi, it was late at night, I was driving home, and I was in high school. I heard the song “Day ‘N Night” come on for the first time ever, and I honestly think it was back when it had barely begun gracing the radio with its sweet sound, and before most people even knew about Cudi. I remember instantly being addicted to the sound of this new artist, of this new song. I tried to go home and Google the lyrics, as the song ended when I pulled in my driveway, but alas, it was to no avail. Maybe it was too early in his career, but I remember craving that song and frantically searching for it for awhile that night, getting nowhere. I felt the song was going to be big. Low and behold, months later I heard the song again, heard the artist, and Cudi blew up. I immediately wanted to hear all of his music.

Music has been a major motivator and interest in my life, I’m always searching for what’s next and really relishing what I have listened to for years. I’ve been addicted to hip-hop/rap since Usher’s “Yeah” (yup, that was what did it for me as a acne-ridden middle-school kid), and Cudi just fit right in. That quote is from a great song of his, and it’s something that I’ve never forgotten since the first time I heard the song.

That quote is just completely, undeniably true. Anybody can take something simple and make it super complicated (take a Rube Goldberg Machine for example). but it takes a true genius to take something complicated and make it incredibly simple. I could go on explaining to my patient the intricacies of a heart attack (aka myocardial infarction), talking about vasospasm, thrombosis, coronary artery occlusions due to atherosclerotic plaque rupture, how cardiac arrhythmias are what kill a person, blah blah blah. Or, I could simply state, “Your heart needs blood to do its work, just like every other organ in the body. Blood has oxygen. Your heart needs oxygen. If your heart doesn’t have blood, it doesn’t have oxygen. A heart attack is what happens when your heart doesn’t get enough blood, and doesn’t get enough oxygen, so it gets hurt. That makes bad things happen”. That might be a very-childlike way of explaining a heart attack, but being able to take all of those factors that go into a heart attack and distill it down to something simple is a work of art.

As medical students, we are generally intelligent people. And by that, I mean you can be the smartest person in the room and still feel dumb. A lot. I’ve gotten very used to feeling dumb. The more I’ve gone on, the more I’ve appreciated the ability of certain professors to “dumb stuff down”. That’s the kind of simple stuff we’re going to remember. That’s why resources like Pathoma (aka THE BEST THING SINCE SLICED BREAD) have become so popular to medical students. It is, dare I say, a necessity nowadays for learning pathology. Pathology is the study of disease, and it can be incredibly complicated. Pathoma is a video-lecture series run by a pathologist out of Chicago named Dr. Sattar, and he walks through incredibly complicated disease concepts in the simplest of terms. He hand-draws most of his own figures and spends time explaining things that even high-school me could have at least somewhat understood.

Let’s take a quick example. We were learning about iron deficiency anemia in my pathology class. This is when you don’t have enough iron for whatever reason. Your red blood cells have something called hemoglobin inside of them. Hemoglobin carries oxygen around your blood, your body needs iron to make it. If you don’t have enough iron, you don’t have enough hemoglobin to go around, and therefore you can’t make enough red blood cells. Without enough red blood cells, you can’t get enough oxygen around your body. Without enough oxygen, your body isn’t too happy.

My professor was explaining this topic and he, like a lot of them do, use these big, overly-complicated diagrams to explain how iron gets into our body. Here’s that diagram. That’s a mess, isn’t it? Here’s how Dr. Sattar explained it: with two, crappily drawn diagrams, number one and number two. I’m no doctor (yet), but those are definitely a lot simpler. I feel as if a lot of professors have a problem with this, especially at graduate and professional levels. The first time I’m learning something, I want it to be so simple a third grader could learn it. I’m going to learn the simple parts and build from there. That’s how my understanding of the world works, and I’m sure a lot of yours as well. Dr. Sattar made such a complicated concept…simple.

Simplicity is a thing that can get lost in the medical world. Our understanding of medicine today has become increasingly molecular, espeically as we learn more and more about the inner workings of the marvelous human body. It’s seriously mind-bending how much we know, and how it all works together in unison. With this advancement, we still need to remember that the noobs of the medical world (medical students) need it taught to us in idiot speak. I’m not going to remember anything about iron deficiency anemia until I first know what anemia means, what iron is used for, and what it means to be deficient. Sounds stupid, but it’s necessary. Then we can get to talking about transferrin, ferroportin, etc, etc. Dr. Sattar knows this and explains it sooooooooooooo simply. He knows that his audience is new to the world of disease, and brings it to where we can easily understand. This might sound like an advertisement for Pathoma, but if you’re a medical student, make sure you get it for your second year. There’s a reason why everyone love Pathoma, Dr. Sattar, and great teachers in general – they know their audience and how to best give them information.

That’s a take away point that I’ve learned about good presenters, teachers, and speakers: they make things simple. Then you can guide your audience to the more complicated parts as they digest the big building blocks first. My goal is to always make things simple. That’s a skill that people cherish and are in awe of. I want my patients one day to say, “Man, that doc really explains things in a way I can understand” even if they hardly have an education. No patient’s daughter walks out impressed and goes “Man, I really understand the role of atherosclerosis in my mom’s myocardial infarction”. We as physicians must be adept communicators, able to translate the word vomit (and whole other language, for that matter) that is medicine.

With the vast amount of information I have to digest, I can only hold on to a few words at best. If those are the simple words that bring the concept full-circle, I’m much more apt to understand it.

I’d like to challenge you to keep things simple in your life, too. Especially if you’re in a field that can be increasingly complicated, and double for if you have to interact with us “laypeople” outside of your profession. After all, who doesn’t like being congratulated?


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