"Both are Better"

He would have been hardly three years old - but, I used to (and still do) call him "Professor" - so to maintain anonymity - let's call him just that - "Professor"One day, my son who was also three then and one other friend of his - also three - spent an intense half an hour making complicated contraptions out of "Leggo". Expectedly, at the end of the exercise, a fight broke out between them as to whose contraption was better.All this while, "Professor" was sitting by my side admiring a "model train" catalog.Pretending not to notice, I was watching the spectacle. The two kids then approached "Professor" and asked of him the obvious question."Hey! Who's Leggo is better? "Professor" took a while to answer. I pretended not to listen simply because I didn't want to get involved in this sticky situation of three-year-olds.But "Professor" was unperturbed. After a brief look at the pieces he pronounced his judgment"Both are better"I almost fell off the chair I was sitting in. Was I a witness to the first wise words of mediation spoken by a future Secretary-General of the United Nations?Being diplomatic does not come to us naturally. We tend to find fault in others and find joy in pointing this out to them. "Wus ho kya aatha hai?" is the KEM trade-mark. That is normal; that is what most kids do - no adult "etiquette" or finesse for them - they call a spade, a spade.But when you are a doctor dealing with numerous colleagues and patients, being truthful about everything - literally - is not always the best way around. Being a radiologist you learn this early in life. "Be nice to the referring physician" we are taught. Else "You will starve for want of patients". So early in life we learn the art of correcting, gently and unobtrusively, barium films hung upside down on the view-box by senior surgical consultants or a neurologist who has the lateral film of the cervical spine upside down and is expounding the findings in a cranio-vertebral anomaly!Early in life too, we are taught the art of "how to hedge". There are no better fence-sitters than radiologists. The better their command over the English language, the better fence-sitters they turn out to be. Here is a typical example of a "Conclusion" in the report on a chest film""The remote possibility of the probability of this lesion being a malignancy cannot confidently be ruled out on this film. However in view of …… a CT scan may be done if so indicated clinically. This report says a lot without saying anything. In the court, I have protected my backside! Or consider this " I am not sure, I do not disagree with you" Only "weather reports" can beat such "diplomacy".All considered, I feel being diplomatic, is good training. When some one says "I think this is a benign ulcer", instead of retorting "No I think it is malignant" - it does not take much effort to say " It could be.. it is of course possible, but I think it is almost certainly malignant'. You friend will get the idea and ask for a biopsy. He will not send a sleepless night over how he had made a fool of himself. One needs to be particularly careful especially when discussing "mistakes" committed by fellow physicians in front of patients. When it is a honest error, or mistake and not a case of negligence, there is no need to rub it in; gently explain to the patients how such things can and do occur - after all no one is God.. Remember, one day the shoes may be on the other foot,So, dear resident, learn early in your resident life the truth expounded by a three-year old. In life, it is often a case of "Both are better"!

January 2003