Drinking from the Fire Hydrant

by Chandler O’Leary, OMS-II

This article was originally published in the March/April issue of the Tarrant County Physician. You can read find the full magazine here.

Medical school has one primary goal: passing on humanity’s medical knowledge to a new generation. There are a few challenges to accomplishing this goal. First is a static problem, i.e., the sheer magnitude of information. Second is a dynamic problem, i.e., the rate of change of this information. Humankind’s medical knowledge is growing and being refined at an incredible rate. These forces are constantly at play in medical school, and they only become more obvious the deeper one’s understanding of a topic becomes. Learning more means absorbing all of the idiosyncrasies and all of the exceptions as well as confronting the burden of complexity. This is a problem that our species has been dealing with forever. Just take the ancient story of Adam and Eve; life was simple until they ate the apple and had to deal with the consequences of knowledge. 

“Drinking from a fire hydrant” is the analogy often used to describe the intensity of learning in medical school. This is what medical students volunteer for beginning in year one, and it will continue until we retire. The best and only solution is old-fashioned hard work and careful thinking. This is the reality that you have to accept if you choose to be a doctor. Unfortunately, this same reality of drinking from a fire hydrant now applies to our whole society that is woefully unprepared for the flood of medical knowledge and information. 

Our society’s fire hydrant does not come in the form of a pathology textbook, but in the form of the Internet and social media. Everyone is bombarded with health content, and the mishandling or misinterpretation of this information has many potential problems. These can range from wasted patient resources to creating false expectations—they can even lead to physical harm. As doctors we become familiar with information overload and have the opportunity to develop strategies to handle it. We learn to be skeptical, research thoroughly, test our assumptions, and rely on experts. It is sometimes easy to assume the whole world has some of these strategies too, but this is obviously not the case. I don’t even need to give a specific example, just browse Twitter or Facebook for a few minutes and I am certain one will present itself. Ideally, everyone would have instant access to a healthcare worker to help them navigate the things they see online. This is currently impossible, so many patients will have to sort through the overload of truth and misinformation on their own. In light of this problem, I am reminded of a famous quote by a pillar of our profession:

“One of the first duties of the physician is to educate the masses”¹

–Sir William Osler.

I believe that we can benefit society by educating our patients about strategies to sort through medical information they find online. Strategies like having some skepticism toward this information, researching it through reputable sources, and trying to disprove something they see on social media before they believe it. Strategies that we have had the opportunity to develop through our medical education.

I am like most second-year medical students and I am probably too eager to share what I have learned with those around me. What has been surprising to me is that most of the health questions my friends and family ask or the incorrect assertions I hear are different from what I expected. For every time I get to explain how someone’s medication works, there are five times of disputing something someone saw on social media. I understand that not everyone has the benefit of medical school, but I fear that the massive amount of online health information has the potential to cause harm if people do not have basic strategies to handle it.

In closing, I will admit that the quote I used was not complete. The full quote says that “One of the first duties of the physician is to educate the masses not to take medicines.” I completely misrepresented the quote because it demonstrates how the simplest strategies can be used to check the validity of something you read. One Google search is all it takes to gather evidence that I was not being completely truthful with Dr. Osler’s claim. That being said, if Osler were alive today, I believe he would agree with the sentiment that “One of the first duties of the physician is to educate the masses not to believe everything they see online.”

¹Osler, William, Robert Bennett Bean, and William B. Bean, Sir William Osler Aphorisms: from His Bedside Teachings and Writings, (New York: Schuman. 1950).