They say to become truly educated is to begin to realize how little you really know.我以前不明白这一点-似乎我学到的越多，我知道越多。How could it be different?这在医学院发生了变化。直到那时，随着我受教育的日复一日，我才开始感到越来越无知。
Each day in medical school,浩瀚的知识从天上倾泻而下。Learning at the pace demanded of us is likened by many to trying to drink from a fire hose — a comparison I thought was silly before I realized it was accurate.The curriculum of medical school is roughly what one might expect — most of our time is spent learning bepaly手机官网about the human body in health and,更主要的是，在疾病中。我们的课程中充斥着关于如何认识，diagnose and manage disease.But our discussions of these maladies are,almost always,仅限于与临床相关的内容。Which is to say,,much,更多could be taught to us bepaly手机官网about these diseases than what actually is.
我时不时地瞥一眼那些超出临床意义的东西。Due to either a special interest or,more often,a profound confusion,I venture beyond the lecture material and open a textbook or look up a scientific paper.超越临床意义的土地是可怕的，因为它的巨大和压倒性的复杂性。每一种疾病都是它自己的世界；临床展览就像这些巨大而复杂的世界投在墙上的阴影。Each day in the classroom projects the images of ten,二十或甚至，忙碌的一天，三十个新世界。And there are enough human diseases to suggest that this pace could continue for the rest of your natural-born life.
Our time in the lecture theatre is punctuated by clinical encounters with real patients usually once or twice per week;这些场合显示出全新的无知形式。一方面，这些事件暴露了我不知道如何治疗的无数病人。What's more,疾病的其他方面让他们自己知道。Rigorous scientific,conceptual understandings of diseases as entities in their own right are nudged aside by human,疾病的叙述印象。当然，不能仅仅忘记bepaly手机官网about all the science,但是我们必须考虑科学以及所有其他维度。Diseases aren't objects;他们唯一的生存领域是people.It is hugely important that a doctor learn to interact with all the humanistic aspects that a patient brings to bear,and,因为每个病人都是不同的人，每一次患者接触都有潜在的教育意义。即使你成功地学习和理解了疾病的所有科学方面——症状和体征，病理生理学和相关基因——还有更多的信息要知道。
A bit of cognitive dissonance arises from the fact that,虽然我们的教育不是为了让我们了解一切，we are in another very real way expected to know everything.The expectation is present in society at large — don't you want your doctor to know everything?— as well as in most medical schools.我记得在第一个课程中有一个考试前复习课，Blood & Immunology,of the first year in which a classmate asked the professor what were the most important points from one of the assigned readings.这门课有很多指定的阅读材料；my friend was asking bepaly手机官网about one in particular that had been prepared as a word document by the professor and contained everything we could ever hope to know about neutrophils (one of the bacteria-killing cells of the immune system).这份文件是，as you may imagine,a bit on the hefty side,and my classmate was curious as to which main points of emphasis we should observe.
教授脸上一片混乱。他的结肠绷紧了，脊柱因愤怒而僵硬。他所钟爱的指定读物中的任何一部分可能不值得我们最深切地考虑，也不值得我们全神贯注地去研究，对他来说，深不可测的Our laziness baffled him."This is medicine!"he exclaimed."你必须了解一切！""
以一种非常真实的方式，this is what one signs up for when one accepts an offer of admission to medical school.On the very first day of orientation,副院长对我们说，"从今天起，your education is no longer for yourself.这是给你的病人的。”当你在睡眠方面落后几个月的时候，参加一个关于睡眠的讲座可能有些讽刺。or in hearing your dietetics professor recommend no more than 400 mg caffeine daily when you are pretty sure no one has ever made it through medical school on that paltry amount (sincere congratulations to anyone who has).但是，沉溺于这种讽刺之中，就是错过了整个努力的重点。
The struggle is not in vain.The workload that at times seems crushing is necessary to develop the skills and knowledge needed to enable the project of medical practice.在这一过程中，人们看到了令人向往的能力，预示着未来，hopefully,专业知识。几周前，我正确地诊断出了粘连性包囊炎。a rare cause of shoulder pain.同一周，我浏览了一个病人的病历，从他们目前的药物列表中得知了呋塞米，地高辛，and metoprolol — that they were suffering from congestive heart failure.Baby steps,不过，还是要采取措施。当然，我永远不会知道这一切；neither will any other doctor,and,当然，医学生也不会！But,as always,the safest bet seems to be to aim high,fall short now and then when it's unavoidable,然后继续向上瞄准。