Emotional engagement in learning through humor and storytelling
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COMMENTARY
Emotional engagement in learning through humor and storytelling George A. Taylor 1,2 Received: 17 April 2020 / Revised: 17 April 2020 / Accepted: 19 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Early in my career, I spent much of my time as a pediatric trauma radiologist. One of the cases that has stayed with me was a young boy who came in to the hospital with increasing abdominal pain after a handlebar injury. He had taken his older brother’s bike without permission and delayed telling his parents about his pain for fear of worse retribution from his brother. The only finding on his abdominal CT scan was a 3-mm bubble of gas located anterior to the surface of the liver. After discussing the finding with his surgeon, he was prepped for a laparotomy. And then … the surgeon called for me to come to the operating room. This would be either very good or very bad news. He had found a complete transection of the jejunum! I often include this story when I talk about the role of CT in identifying bowel injury after blunt trauma. To me, it represents so much more than entertainment or a waste of precious minutes. To begin with, it helps me reinforce that it is the presence of pneumoperitoneum and not its amount that is most important in making this diagnosis. It also allows a number of other very important processes to take place. Telling this story engages my audience in the process of being a radiologist on the front lines. Would I have missed this small finding? Would I have dismissed it as unimportant because of its small size? How would I have communicated this finding to the attending surgeon? How would I have reacted when called to the operating room by a senior surgeon? Another story involves my first weekend on call as a staff radiologist. A 3-day-old infant was brought to the department with abdominal distention and failure to pass meconium. There were signs of distal bowel obstruction on plain radiographs, with no gas seen in the pelvis. A surgical resident
* George A. Taylor [email protected] 1
Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104-4399, USA
2
Department of Radiology, Boston Children’s Hospital, Boston, MA, USA
asked whether an enema was indicated. With a great deal of confidence, I told him not to bother, because the child had Hirschsprung disease and needed to go to surgery. A few minutes later, my chairman came by to pick up something in his office. Wanting to impress him with my acumen, I pulled him over to show him the images, and the great diagnosis I had made. He approached and patted me on the shoulder, saying, “Great case … of meconium ileus!” The baby promptly made it back to the department for the confirmatory enema. Stories can be a useful tool in a number of ways. They can help cement the key learning points about pediatric diagnosis. They can also create a safe space in which to think about potential challenging scenarios — such as how to handle difficult diagnoses, and how to ap
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