“All I really need to know I learned in kindergarten” 

By Maxwell Droznin, MD, MPH, Johns Hopkins Medicine  

On a chaotic overnight shift during intern year, I ducked into a staff bathroom in the ED. Taped to the inside of the door was a large poster of Robert Fulghum’s poem “All I Really Need to Know I Learned in Kindergarten”, complete with a bright red apple and cheerful text beneath. The sign on the outside of the bathroom door instructed staff to keep the door closed at all times. It rarely was. The poster greeted anyone passing through the hallway, an oddly wholesome fixture in an otherwise sterile corner of the department.  

The poem’s message is that the most basic lessons—like being kind and sharing—are learned in childhood and are fundamental to helping others, living a good life, and making the world a better place. I had to laugh though—I imagined explaining to an attending that I’d managed a STEMI using principles from the sandbox.  

When the poster became my nemesis 

By second year, I stopped laughing. The poem began to feel patronizing. I remember sprinting from my team room on the fifth floor to the ED for a boarding patient whose condition had changed. I was exhausted, overwhelmed by what I didn’t know, and terrified that my gaps in knowledge would hurt someone. On those days, catching a glimpse of that poster felt almost insulting.   

When the poster started making sense  

Then something shifted. I began noticing what patients remembered about their hospitalizations. It was rarely my medical decision-making. It was whether I sat down. Whether I asked about their grandchildren. Whether I held their hand when delivering difficult news. One patient, a retired teacher admitted for heart failure, spent our last conversation together telling me about her late husband. She thanked me at discharge, not for optimizing her diuretics, but for listening. “You made me feel like a person,” she said.  

I thought about the poem differently after that. Hold hands and stick together. Be aware of wonder. Say you’re sorry when you hurt somebody. These weren’t naive platitudes. They were instructions for being human with another human during their most vulnerable moments.

The tacit agreement  

Now, as I prepare to graduate residency and enter academic medicine, I pass that bathroom with something like gratitude. The poster was right all along, just not in the way I first understood. Everything I learned after kindergarten is essential for practicing medicine. But everything I really need to know—how to be present, how to be kind, how to see a whole person and meet them where they are—those lessons came first.  

I smile at that poster now. We have an understanding.  

Here are few things the poem continues to remind me about:  

1. Sit down.

Even briefly, it signals presence.  

2. Ask at least one non-medical question.   

Their pet’s name or their favorite hobby. It costs seconds and means everything.  

3. Revisit the basics.  

When medicine feels overwhelming, return to the fundamentals of human connection.  

4. Forgive yourself.  

The poem also says to say sorry when you hurt somebody, including yourself. 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.