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‘Jesus, that’s a long time to be in training!’
We’ve all heard this one. Given medical training takes between nine years (for a graduate-entry GP) and 16 (for a neurosurgeon who intercalated), it’s fair comment. And precisely because it is so long, there are plenty of opportunities, over the years, for all kinds of people to tell us so.
This time, the remark came from the builder fixing my landlord’s bathroom. He’d knocked off for a tea break and it had seemed only polite to have a chat.
I pointed out that, actually, most trades and professions have long training, even if an informal one. For example, didn’t he himself have to keep learning about different building techniques, or maybe new materials?
He agreed enthusiastically. There was always lots to learn in the building trade – so many new things to keep track of, so many skills to brush up.
‘But for you,’ he said, ‘there’s one main thing, isn’t there?’
‘There is?’ I asked, puzzled. Did he mean human physiology? Surgical technique? Bedside manner? That thing,’ he said, snapping his fingers in irritation at his inability to bring the word to mind.
‘That thing you wear round your neck.’
Finally I grasped it. The stethoscope. For this man, the stethoscope was not only the symbol but the actual locus of medical expertise. If we could master that central tool, and all its mysteries, we were doctors indeed.
OK, I had to rely on those many years of training to suppress a smile. Few adults with much formal education would share the builder’s view – or at least express it so unselfconsciously. But the stethoscope does have a special place in medicine, which goes far beyond its practical utility.
I use my stethoscope on a daily basis, to check for bowel sounds, to assess air entry or to listen for a murmur. That’s not all I use it for, though. I use it as a badge of identity, wearing it round my neck when I meet a new patient, even if I have no plans to auscultate anything.
I use it to reassure family members, as they watch me go methodically through the ritual of examination. I used it to examine a nervous child, starting with their chest, even if I’m really looking for a cerebellar lesion – because that’s how Dr Brown Bear examines Peppa Pig.
It’s by no means only theatre. For now, the stethoscope is still genuinely useful. But even when it’s been well and truly superseded – by ultrasound, genomics or even the tricorder – will we be ready to leave the time-honoured emblem of our profession behind?
By the Secret Doctor
Read the blog and follow @TheSecretDr on Twitter and on Facebook
Well not so much of an identity anymore or at least for me. I don't know whenther it is me being a British Asian or not but many nursing staff members, "Despute my big littman stethoscope around my neck" first ask ....are you the pharmacist around here?...it feels so irritating now and to be frant quite discriminating...and I always say to them ...hellloooo I am wearing a stethoscope but some of them still just not.see it I guess.
Moreover with the additio of " Physician associates" to the wards now , with them wearing no uniform like ANPs...distinction between a doc and a PA is completely gone...dont know whether it was the plan all along but anyways stethos ope identity of a doc is dying....unless they start white overalls again like in the US.
Do you not also use it as an impromptu tendon hammer when a real one is nowhere to be seen? ;)
Good article about identity - I also remember being beyond thrilled to receive an NHS lanyard when I was shadowing before I even joined medical school - it felt so special to be part of that wider team and still does.
I remember a meeting with the Trust's Chief Medical Officer and some managerial chap that I was invited to a few years ago in my capacity as mess president. They were attempting to force the introduction of uniforms for junior doctors. I remember them saying that the juniors "lacked a sense of corporate identity within the Trust".
I pointed out that every member of staff recognised a junior doctor - they were the people walking twice as fast as anybody else who had a stethoscope around their neck! The steth as a badge of identity is something I fully understand.
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