Insights from “See One, Do One, Teach One”

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Dr. Grace Farris’ graphic memoir, “See One, Do One, Teach One, The Art of Becoming a Doctor” is a wonderful trip through the author’s medical training, from the beginning of medical school, through residency, and into her current life and practice. Dr. Farris provides numerous vignettes not only of her clinical experiences, but of her personal and professional relationships as well.

Graphic medicine

Graphic medicine, or the use of comics in healthcare, is a field that lends itself well to a work such as “See One, Do One, Teach One.” There are many drawings and accompanying word balloons that aptly describe and demonstrate feelings associated with learning and practicing medicine. The illustrations of the clinical situations are effective, but, well, not too graphic.

An opportunity for reflection

While viewing Grace’s reflections on her training, clinicians can’t help but reflect on their own experiences—and perhaps look at learners, patients, and themselves in a different light.

For example, Grace expresses misgivings about gross anatomy and even turns green and steps out during the brain dissection. Medical school professors should remember that that body donor dissection can result in powerful emotions. Despite her second thoughts, Grace persevered, worked with her peers, and had an “aha” moment while dissecting the human ear (that’s well diagrammed in the book). She described that as a turning point in her developing professional identity.

Simple and effective drawings and word bubbles

The clinical years of medical school are depicted simply and effectively. One can imagine the heightened alertness Grace must have felt during a nighttime emergency, with the comic showing “CODE BLUE!” in bold print overlying the darkened hospital. As a reader who’s spent many days and nights in the hospital, I could almost hear the announcement. And as an orthopedic surgeon accustomed to early rising, I could relate to (was amused by?) the comic of the alarm clock showing 4:30AM, and another of just a light or two on in an otherwise dark house and neighborhood as Grace gets ready for the day on her surgery rotation.

Clinically excellent care

“See One, Do One, Teach One” has many representations of clinically excellent care. On her internal medicine rotation, for example, Grace was assigned to a resident, Julie, who had a wonderful bedside manner and was both cheerful and respectful. In one scene, Julie interviewed a patient who may have developed serotonin syndrome from taking too much medicine, and she remained matter-of-fact and nonjudgmental.

There were also a number of scenes where Grace showed that medical students can also demonstrate clinical excellence. In one, Julie asked Grace to evaluate a patient with chest pain who’d already had several medical tests. But no one before Grace had examined the patient’s chest. In the illustration, Grace asks the patient to show her where the pain is. After exposing the symptomatic area, Grace identified the telltale rash of shingles—her first diagnosis!

Not-so-excellent care

The book also shows some less-than-ideal attitudes and behaviors by clinicians such as stigmatizing and blaming patients, using derogatory expressions, and even throwing a surgical instrument in anger in the operating room. The scalpel flying over the exposed wound with the surgeon’s word balloon showing “?!#@$!!” is a particularly effective drawing of an unacceptable response. One can learn from viewing and reflecting on these depictions where care may fall short.

Personal life

There are aspects of Grace’s personal life that bring a smile, such as meeting her boyfriend Arthur, a journalist, and falling in love with him. The comic showing two clasped hands is a sweet moment, and those of Grace practicing physical exam skills on good-sport Arthur are very amusing.

Navigating a tsunami

Sir William Osler, the namesake for CLOSLER, famously said “To study medicine without books is to sail uncharted seas, but to study medicine without patients is to never go to sea at all.” In her memoir, Grace felt like she was “navigating a tsunami” on a fast-paced internal medicine rotation. The accompanying drawing of a small sailboat trying to stay afloat on top of huge waves while lightning strikes illustrates that feeling very well.

My reflections

“See One, Do One, Teach One” provides many wonderful examples of medical training and care that may benefit medical students, residents, trainees, medical educators, and experienced clinicians alike. The graphic medicine medium lends itself well to a medical memoir such as this. In reading Dr. Farris’ account, I find myself reflecting on my own experiences and practice.

Becoming a physician is a deeply human process. Medical students such as Grace (and myself back in the day) are eager to learn while they may harbor their own anxieties and doubts while navigating school and their personal lives. It’s important to support trainees along the journey. Celebrate the achievements, milestones, and  “aha moments,” of trainees and colleagues.

The book is also a reminder that patients are facing their illnesses with fear and uncertainty, and they deserve to be met with patience, respect, and empathy. “See One, Do One, Teach One” shows us that reflecting on where we’ve been can help us become more thoughtful and compassionate clinicians and educators.

At the end of the book, now in clinical practice, Dr. Farris considers the changes that have taken place since she started medical school—a growing family, new medicines and technology, and even new fashionable scrub attire.  But one thing remains the same—the human connection.

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