The JIPMER CONNAISSANCE ADDRESS: honing creativity among medical graduates (The Top Secret)

However, formal education in kindergartens and primary schools tend to expect “uniform” answers rather than the “diverse” reflections of curious minds. The tendency to ask “whys” among children tend to decrease as they advance to higher classes. The orientation is strongly conditioned to the decimals of the marks in examinations, rather than allowances of creativity; and many around the child look for measuring her/him based on these numbers (marks!). Added to that is the shaping of the Child’s mind, to the interests, aptitude and aspirations of other actors (parents, teachers, friends!).

“From an early age we are given labels which can so easily define our lives” : Richard Gerver. 2013 .“Change – learn to love it, learn to lead it.”.

The efforts of creativity at a graduate level would be to retain and nurture the ability if they are tuned to, or to develop this lost ability (which every individual is born with).

But then, we need to undo/redo from this conditioning, in medical education to bring out the best of a medical graduate for society and themselves. Explore ourselves to discover, which helps to a holistic and “best of potential delivery” to the society. The programme of Connaissance 3.0 is such an opportunity to pause and reflect on the passionate abilities we would have otherwise forgotten or kept in the uncared corners of mind.

Nissen, Einstein and the cellophane:

The following paragraph is a paraphrased version borrowed from the amazing book “Under the Knife : The History of Surgery in 28 remarkable operations by Arnold Van De Laar (2018).

Rudolf Nissen (who fled Germany owing to 2nd world war), is credited with the operation of Nissen fundoplication ; he performed the first successful resection of a whole lung (1931) and was the first to perform a complete resection of the oesophagus. Albert Einstein needs no introduction. He left Germany in 1933 for reasons evident to history.

In 1948, when Einstein was 69 he was the most famous patient Nissen could have imagined to treat in USA.. Nissen diagnosed AAAA( Acute abdominal aortic aneurysm) in Einstein with Xray studies ( since CT scan and ultrasound scan were not developed). As Nissen performed the abdominal operation on the greatest scientist of the world, he found an aneurysm of the abdominal aorta, the size of a grapefruit.

As the aneurysm was still intact, Nissen applied an experimental method : he wrapped it in cellophane – the same synthetic material used to wrap sweets, bread and envelopes. (Use of vascular prosthetic surgery superseded this in the years that followed). “ and it required guts to wrap the aneurysm of the greatest scientist of all time …” To cut short an interesting and epic story I focus on “guts’.

This “guts” is the confidence what I call a “confluence of competency and compassion” of surgeon/doctor: the quintessence of medical education. The capacity of common sense, improvisations or innovations, timely and quick reactions and above all the ability to comprehend the whole situation and act firm and fine in the best interest of the patient.

Where does it come from ?

Undoubtedly, from the creativity of stretching minds of imagination. Medical education is a confluence of Competency, Creativity, Connectivity (especially in this Google age!) and Compassion. Competencies are built through the well thought of curriculum of five and half years: the Skills. Knowledge and mindset. However, the other abilities are to be nurtured and ignited through an ecosystem favouring liberated minds that will synergistically benefit the community, doctor and above all the profession.

Honing creativity

Dare to think !

It’s amazing how we can study history, anthropology, arts, architecture and many more interesting areas of life through medical science. In the talk that followed mine, Dr. Deepak Agrawal (Professor Neurosurgery, AIIMS Delhi, Co-inventor of World’s Cheapest Ventilator) interestingly explained on how he could see a plot or design of a human brain in a painting of Michael Angelo. This perspective is creativity. He has helped in transforming the corridors of AIIMS to have an art gallery with paintings for the patients and public who visit AIIMS.

This is what creativity does to a doctor, and the reason why creativity and innovation need to be complemented in the period of medical education. It’s the ability to see the same situation in different perspectives.

And in India, it all needs to be approachable and affordable for the common patient.

The algorithm of diagnosis

In this technological era, we are moving from the “Sherlock Holmes method” of diagnosis to “ the artificial intelligence” (AI) methods” like the Magic of Watson’s algorithm (IBM).

“Today IBM will feed a medical Watson, 3000 images, 200 of which are melanomas and 2800 are not, and Watson then uses its algorithm to start to learn that the melanomas have these colours, topographies and edges. And after looking at tens of thousands and understanding the features they have in common, it can, much quicker than a human, identify particularly cancerous ones. That capability frees up doctors to focus where they are most needed – with the patient.” Thomas L. Friedman. 2016. “Thank you for being late : an optimist’s guide to thriving in the age of accelerations”.

The balance between the technology and patient helps to retain intuition, empathy and judgment the vital parameters of a doctor’s life. Retaining the personal qualities in the tirade of technologies is a challenge. Creativity is one of the solutions to the sweeping technologies, which can build on identity!

The key mantra is : Man reins the machine.

Faculty orientation.

The present generation students are born into the fast track of technologies that decide day to day life.

“Subject and wisdom” wise, we assume faculty are experienced. But the faculty need to give a wider and open space for the enhanced capacities of the brilliant students who are a product of the present time and technologies – the Google generation born in to the “smart worlds”. There is a lot about the world that is to be understood from students!

The lateral learning from different walks of arts and science helps in good innovations. Whether it’s a book, movie, music or maverick – creativity sees innovations when we open up interfaces with these.

The disciplined knowledge of the doctor synchronised with the skills and knowledge from different realms of science and arts open up new avenues and innovations.

“Learn – unlearn- Relearn” is the key to open the lock of a closed mind.

Innovation clubs/café

These can provide spaces for students, staff and others (be it patients or outsiders) to discuss on lateral thinking. These can be informal centres of coffee breaks, wherein ideas are shared and the ones are taken forward through a good innovation facilitation centre.

Epilogue: The Top Secret

The secret of the Top is to spin it.

A still top doesn’t qualify to be called a top. We all have been blessed with a top. The question is how many of us has spun it and how many times!