The house officer looked at the film on the light box and thought of the elderly physician resting in bed across the corridor. Despite two previous chest drains, a pneumothorax persisted around the left lung. To make matters worse, one of the holes in the side of the remaining chest tube was in that ‘no man’s land’ between the pleural cavity and the skin. Thus the old physician had begun to slowly swell up, mimicking the Michelin man. The chest film showed a rib cage rimmed with a thick layer of blackness.
The house officer explained the situation to his patient; the old physician understood perfectly. For a third time he would undergo the ordeal of chest tube insertion. The house officer prepared the equipment and enlisted the help of an experienced nurse. Although he knew that the young doctor was not more than half a year out of medical school, the old physician seemed untroubled that such a novice was about to cut another hole in the side of his chest.
As the house officer drew up a dose of morphine, the old physician spoke, “Doctor, at which medical school did you train?“
The house officer told him.
“Ah, well then, do you know John Hunter?“
The house officer’s mind resisted distraction from the daunting task at hand, however he managed to force its focus firstly on his fellow students, then the junior doctors he had shadowed, and finally the consultants and professors who had taught him his craft. The name did not find a fit.
Then a penny dropped.
John Hunter… The man who grafted a human tooth onto a cock’s comb, who stole the corpse of the Irish Giant, who described semen held in the mouth as having a warmth similar to spices and who proved the contagiousness of venereal disease by self-inoculation?
A smile slowly drew itself on the face of the old physician as he closed his eyes. The house officer administered the morphine and began his work.
I am firmly convinced that the best book in medicine is the book of Nature, as writ large in the bodies of men. You remember the answer of the immortal Hunter, when asked what books the student should read in anatomy – he opened the door of the dissecting-room and pointed to the tables.Osler W. The natural method of teaching the subject of medicine. JAMA 1901;XXXVI (24): 1673–9.
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health, a Clinical Adjunct Associate Professor at Monash University, and the Chair of the Australian and New Zealand Intensive Care Society (ANZICS) Education Committee. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of LITFL.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of two amazing children.
On Twitter, he is @precordialthump.