Im a great believer in geography being destiny.
Students undergo a conversion in the third year of medical school – not pre-clinical to clinical but pre-cynical to cynical.
Certainly when I got to medical school I had role models of the kind of physicians I wanted to be. I had an uncle who looking back was probably not the most-educated physician around but he carried it off so well.
My sense is that the wonderful technology that we have to visualize the inside of the body often leaves physicians feeling that the exam is a waste of time and so they may shortchange the ritual.
I think we can see how blessed we are in America to have access to the kind of health care we do if we are insured and even if uninsured how there is a safety net. Now as to the problem of how much health care costs and how we reform health care … it is another story altogether.
My desire to be a physician had a lot to do with that sense of medicine as a ministry of healing not just a science. And not even just a science and an art but also a calling also a ministry.
When I use the word healing by that I mean that every disease has a physical element that were very good at handling but theres always a sense of the violation. Why me? Why is my leg broken on the ski trip and not anyone elses? And I think that medicine has done a terrible job of addressing that spiritual …
The flip side of suicide is that it leaves a lingering question in the minds of the people who survived. Its like a cancer thats metastasized. The suicide is the cancer and the metastasis is all these people saying Why? Why? Why?
What we need in medical schools is not to teach empathy as much as to preserve it – the process of learning huge volumes of information about disease of learning a specialized language can ironically make one lose sight of the patient one came to serve empathy can be replaced by cynicism.
Ive never bought this idea of taking a therapeutic distance. If I see a student or house staff cry I take great faith in that. Thats a great person theyre going to be a great doctor.
Patients know in a heartbeat if theyre getting a clumsy exam.
Though I am fascinated by knowledge I am even more fascinated by wisdom.
Im the first to admit that the resolution of a hand feeling the belly doesnt compare with the resolution of a CAT scan scanning the belly but only my hand can say that it hurts at this spot and not at this spot. Only my hand can say that.
Theres something universal about illness… Whether you like it at some level all patients are saying Daddy Mommy help me tell me its going to be alright.
Medicine may be the lens through which I see the world but since I think of medicine as life + a place where life is exaggerated and seen at its most vital and poignant Ill be writing about life more than I will be writing about medicine.
Modern society has evolved to the point where we counter the old-fashioned fatalism surrounding the word cancer by embracing the idea of the Uber-mind – that our will possesses nearly supernatural powers.
The incredible cinematography makes A Walk to Beautiful almost like a poem there is a tenderness on display that seems to emanate from the camera. There is also great sensitivity to the women whose stories are being told – never did I have a sense of the subjects being exploited.
For one who has an interest in the body as text airports are treasure troves of information. It seems almost un-American to enjoy delays and perhaps enjoy is not the best word but certainly a delayed flight if it does nothing else allows one the opportunity to make prolonged observations about ones fellow travelers.
When you have a natural genetic tan developed over centuries and many generations the idea of soaking up rays by the pool has never made sense.
There are moments as a teacher when Im conscious that Im trotting out the same exact phrase my professor used with me years ago. Its an eerie feeling as if my old mentor is not just in the room but in my shoes using me as his mouthpiece.
I think we learn from medicine everywhere that it is at its heart a human endeavor requiring good science but also a limitless curiosity and interest in your fellow human being and that the physician-patient relationship is key all else follows from it.
Rituals anthropologists will tell us are about transformation. The rituals we use for marriage baptism or inaugurating a president are as elaborate as they are because we associate the ritual with a major life passage the crossing of a critical threshold or in other words
So I consider myself a dog person. Kind of. Had dogs when I was a kid but my parents would never have dreamed of having them in the house.
I think legislation needs to put an end to doctors profiting on businesses to which they can funnel patients – that is business not medicine. If you try to call it medicine then it is corruption. Without legislation it will keep happening.
The bottom line: health care reform is about the patient not about the physician.
Literature is a beautiful way of keeping the imagination alive of visiting worlds you would never have time to in your day-to-day life. It keeps you abreast of a wider spectrum of human activities.