The process of learning involves an 'other'. The other could be a person like a teacher or fellow student, or it could be a thing like a book or computer. Learning medicine inevitably involves the patients whom we treat. The question is: when a junior doctor is operating for the very first time is he 'learning from' the patient or 'on' the patient? Do we always learn from our patients or do we sometimes learn on them, and at their expense?v