Slow but Sure: Persevere Rather Than Rush

Some young medical students have left messages on my official account asking me to write about how to study medicine; I never quite knew where to begin. Just recently, a spate of medical scandals has surfaced. Jokes that even an illiterate person would not make—men with uteri, men with ovaries—have appeared in legitimate medical journals; that the doctors, nurses, and journal editors involved could make such elementary common-sense errors is astonishing. Scandals of people pulling strings into the medical system and becoming medical stars and hospital executives have also come to light, involving even certain academicians.

Colleagues have privately told me these past days that they feel dispirited, because this brings shame on the entire medical and nursing community. The matter has now reached the international press, and without a doubt it has damaged the credibility of our medical establishment. Not only do our professionals fabricate data in their papers, they now fabricate gender as well—a modern marvel. Who will dare trust such papers?

The affair has given me an opening, and I want to expand on it and write a little about my own views on how to study medicine.

First, we must recognize that we now live in an era where professional integrity is uneven, and this backdrop inevitably breeds an ecology in which bad money drives out good. Even so, I believe that those who truly love medicine should still hold the bottom line and not be swayed by the prevailing environment.

Although the broad environment looks poor and medicine cries out for reform from top to bottom, the essence of care never changes: we are centered on tending the sick. Patients know best whether doctors and nurses are competent and whether they are kind. My own direct experience is that a truly skilled caregiver earns patients’ heartfelt trust and respect. That trust and respect are the foundation of our calling; without them we become rootless. With them, even if we hold no titles, patients still trust us and choose us first when they need help.

So if we love medicine, we should pour our energy into mastering our craft and our overall ability to serve patients—including the empathetic understanding and communication skills needed to work with patients and families. These foundational skills require us to learn in the field, with questions; our abilities grow imperceptibly as we solve one problem after another.

This brings us to a very important learning principle that I have stuck to for years: learn guided by problems. I have always been reluctant to prescribe reading lists for anyone—partly because I do not feel qualified, but more importantly because reading by a list is dead reading: interestless and inefficient. Truly efficient learning happens when a problem arises in practice, then we chase it through the relevant literature, read deeply, think hard in light of the actual problem we face, and verify what we have learned in practice.

This method can last a lifetime. I have forgotten almost everything from junior high, but I remember already studying this way in high school. Today many people enter university still not knowing how to begin, always hoping someone will show them the way; that bewilders me, because such students have almost no capacity or awareness for self-directed learning. Anyone over eighteen who still lacks that awareness and ability is not suited to medicine, because a doctor’s life is spent solving difficult problems; it is unimaginable to take on such challenging work without self-directed learning.

Whether or not we face exams and daily work, each day we should set aside time for this kind of self-directed study. Over time, every bit we accumulate becomes a sparkle in us. No matter how comfortable one’s family background, without those sparkles one cannot last on the front lines of care—though of course, if one never really loved medicine, leaving the front lines is a blessing, and such people need not read my article; different ways do not conspire.

Working the front lines demands solid fundamentals, which do not come overnight; they require the spirit of advancing one step a day, persevering without cease. Those who study medicine must avoid impetuosity; chasing quick gains never yields a good physician. Most famous doctors are somewhat reserved and deliberate, because medicine requires long hours on the cold bench. Skilled caregivers are respected all their lives and never materially want. But to earn that, we must first be willing to put in the work to build those fundamentals.

Building fundamentals takes not a month or two, but ten or twenty years—a lifetime. We need not let others’ back-door dealings rattle us; those who rely on connections will never earn these things. Take the long view: many people’s so-called achievements bloom like ephemerals, short-lived, whereas a caregiver with solid fundamentals has a lifetime of worth. Every opportunistic career rests on a shaky foundation; the “internal skill” earned through sweat is not easily rendered obsolete.

From very young I have been expected to solve all kinds of problems for those around me—family, classmates, teachers, friends, patients. A month before my mother died, she said to me, a little sorrowfully, that watching me carry such burdens since I was a child, like a mule or a camel, pained her. After all, she was my own mother; she wanted me to live more comfortably, without so much weight on my shoulders. But I do not see it that way. Being at the center of the vortex, carrying the expectations of all sides, has its costs, but it also forges problem-solving ability. And in this world, the ability people need most is to solve problems; only with it are we not at the mercy of others, and that is the foundation of true dignity and freedom.

Medical students and doctors are destined to need strong problem-solving ability, so if someone dreads trouble, they should not enter medicine as a lifelong calling. If one loves medicine and means it as a lifelong career, one must be glad to face and solve problems rather than avoid them. Lacking thought and fearing problems, a person will never grow.

So if you truly want something from me as advice, I hope it is what I have emphasized in this article. These are not flourish, nor shortcuts; they are a way of learning and thinking suited to our calling—one that must be kept up for a lifetime, like Forrest Gump keeping on running.