Engage… and Go Deep

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Recently, I searched for inspiration for this editorial deep in the city of Nanjing, China. At the Imperial Examination Museum of China, one can learn about the “kaoshiyuan,” small stone cubicles with simple wooden desks where scholars seeking government positions underwent intense examination. It is recorded that at one time over 20,000 of these cubicles existed: the rows and rows of them occupied vast expanses of land often overshadowing other city dwellings. The Imperial Examination System existed in China for approximately 1300 years and ended in the early 1900s during the Chinese Cultural Revolution. The entire process of the system from creation, reform, and abolishment is on display at the museum.
The goal of the examination was simple: find the intellectual elite and move them as close as possible to the Emperor and ruling class. The dominant paradigm during these centuries of dynastic rule was that the intellectual elite should be at the top of the governing and power structure and more importantly that the people actually wanted them to be there. Scholars spent 9 days and 6 nights in the kaoshiyuan undergoing intense examination and thought. The goal of the scholar was to reflect upon contemporary knowledge; display a sound knowledge of language, civics, and history; and perhaps even synthesize new knowledge resultant from this deep thought and examination. Physical skills were also tested where appropriate.
The group of local and visiting professors that accompanied me moved swiftly through the museum. I was lost a few times while gazing at the exhibits and pondering what lessons this past way of life might offer us now. When was the last time you went deep? When was the last time you were able to filter out all of the noise that diminishes your focus and limits your ability to summarize our collective knowledge and develop new inquiry? Does our society identify us as intellectuals and does society give us adequate time and resources to isolate ourselves, reflect, and generate new roads into new knowledge? I don't think so. A deeper question is that, even if society wanted to do this, would society be able to structure the activity and be able to make it happen? Again, I don't think so. Times are perhaps different now.
There are myriad manuscripts published. An even more profound proliferation of educational resources has occurred. We as professionals know there is no time to digest all the resources at our disposal. Yet our experiences in clinical practice often suggest that the public expects us to. The chasm that lies between ability and expectation is wide and deep. Part of what fuels this expectation is that information is so easily accessible. When was the last time you rode a horse for days between villages to learn of new discovery?
Government, the public, hospitals, and other stakeholders all seem to have enhanced supervisory and regulatory roles over the conduct of physicians and what we should know. Yet how we educate ourselves is still up to us. This might be a passing fad, just my opinion, or a paradigm about to last for hundreds of years—in any case, it is what we appear to have. So what I propose is that we continue to leverage all resources at our disposal to achieve the deep thought necessary to create new knowledge in our field. You might be too busy, and we as editorial staff might be too busy, but I feel it is a strong obligation of the editorial staff to assist with this task in as many ways possible.

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