Knowledge is liable, labile, and luxury
– Written by Dr. Geeta Sundar

One of my professors used to say, that a medical student till the point of his post graduation has over 9 lakh pages of books to read.
Simply, aghast, are you? But it’s true. He had counted the least needed but surely important standard books that one would need to read to cover the syllabus across the 6 years.
Reading is an art. I have been brought up with values that have given a lot of importance and enjoyment to reading. But in the case of a doctor’s life, reading is often a terrifying pursuit. We read for fear of not passing an exam, we read for understanding a concept that will be questioned by the professor, we read to prepare for a surgery with doubts and alarming worries.
We read in stress. We read under stress. We read in duress. We read with ulterior motives. We read to achieve secondary gain. Sometimes, reading gets preference over sleep, food and even health. And by the time a doctor gets to his post graduation life, reading is second skin, it represents an emotion, often flagged by simultaneous activities of checking a phone, writing, listening to music, chewing gum, eating etc.
Been there, read that once. Then what happens to that knowledge? Does it evaporate, or does it stay on? Does the knowledge even reach its mark and get embedded into the hippocampus or amygdala? Or does it just breathe into a few neurons and lose its way into the throes of the gazillion connections in the brain?

Whatever piece of that knowledge we retain, let me call it ‘superficial’, is what we use to function in our daily work. Practice makes perfect and we all know it. And so, reading the same thing again can help retain it better. But to what extent? Little bits and pieces of broken knowledge fed by a senior to a junior, to answer possible questions since rounds are akin to a mother bird feeding it’s little baby kakas; is like passive immunity – the concept is weak, shaky, temporary, fragile, built on hearsay with no understanding and can only propel you so far. But reading a standard textbook or a reference article in detail, from scratch leads to concept build up which can contribute a long way to ensuring stable foundations.
I am surrounded by people who choose the easy way out. No one reads standard textbooks anymore, a short read here, a short read on Google scholar, some published work with references is deemed as reading…and they get away with it, usually. That knowledge read in complete hastiness is superficial, baseless and doesn’t help with work. More so, it won’t suffice for concepts and sharing knowledge. Maybe I am the hard worker and not the smart worker, but I believe reading is an aptitude to be built. Each read should have an advantage or contribute to something in one’s growth, or learning.
Superficial knowledge comes at the cost of a patient’s life. Not knowing the entirety of say, the Circle of Willis and all its branches in detail can make you not realize the feeder vessel to an AVM or make you underestimate the classification/location of an aneurysm that is vital. Reading will help in ensuring smooth transition into assisting in OT as your senior surgeon maneuvers a rough terrain of anatomy. Knowledge is key. Knowledge is also life saving – it can come to your assistance when you have a court hearing or have to refute/back up your approach in treating a particular case.
However, knowledge is also slippery. I’ve heard stories from colleagues who know too much, but do too little. “People who write books, rarely do surgery.”, is a testimony passed down from generation to generation of surgeons, and having mentioned that, I think it’s also imperative to know that those who write, can write only because they have read enough to be able to articulate it enough.
Over the last 16 years in this long drawn routine in the medical field, it is my personal experience that reading can save your hide. Literally. Words you see on a page, that can be quoted, can be referenced and can contribute to the changes you make in your practice.
Anyone giving the USMLE exams will testify to this. The depth of the questioning, the deep analytical thinking, clinical application is heavily oriented to reading. A simple skim of the pages will not be enough. Grossly reading every 2-3 lines to finish a syllabus is not adequate. It needs a real inner mental strength to read each case, each subject to all possible recent advances to be able to do well on the exam. It forces a reading habit that inoculates and inculcates right from the medical school days, in contrast to the Indian system.
I met Dr. Paul, a young neurosurgeon from Australia in 2016. He was so well read, well articulated and knew his basics with control. I was simply in awe of his ability to have read so much, and when asked, he said – “Oh, you know, I read the whole of Youman’s sitting in the outpatient clinic daily, I used to target 20 pages or so and it all got done quite easily. And then it was so much simpler to go back and read the notes I made later.” Wondrous. Daily reading! Oh, but that is the real deal.
So, to all of you walking on this path of a tumultuous medical field, read, read daily and read with good intentions. Don’t read just for an exam, don’t read just for the heck of it to prove a point or lazily or inefficiently. Read, because you will learn, and get better and give back better to your patients. Read because knowledge is precious and luck. Read because the more you know, the better your chances at picking up things others won’t and read because, it’s the right thing to do by your patients.