medicine

Recent sociological findings indicate that while "whites have largely abandoned principled racism... they have not necessarily given up negative racial stereotypes" or "negative sentiments and beliefs about African Americans.

In our society, unless something can be measured then it doesn't exist. This is especially true in the world of medicine.

Public "facts" are not like pebbles on the beach, lying in the sun and waiting to be seen. They must instead be picked, polished, shaped and packaged. Finally ready for display they the bear the marks of their shapers.

...by the end of my first week as an intern, I am just about ready to throw my pager out the window. A high window. Overlooking a trash compactor. Filled with highly corrosive acid.

All bleeding eventually stops.

The nineteenth century is called the century of hygiene, and the twentieth is the century of medicine. The twenty-first century may be the century of behavioral change. Changing everyday, long-term behaviors--how we exercise, what we eat--is the key to adding years and quality to our lives.

Failing to listen to the woman is one of the biggest mistakes a practitioner can make.

I welcomed my slavish existence as a surgical resident, the never-ending work, the cries that kept me in the present, the immersion in blood, pus, and tears -- the fluids in which one dissolved all traces of self. In working myself ragged, I felt integrated...

Words began to feel as weightless as the breath that carried. Stepping back, I realized that I was merely confirming what I already knew: I wanted that direct experience. It was only in practicing medicine that I could pursue a serious biological philosophy. Moral speculation was puny compared to moral action.

The medicine it's three times everyday taking cold water shower.

Medicine is a golden goose that has to be killed because every time the goose lays a golden egg, someone gets sick or dead.

The freedom of patient speech is necessary if the doctor is to get clues about the medical enigma before him. If the patient is inhibited, or cut off prematurely, or constrained into one path of discussion, then the doctor may not be told something vital. Observers have noted that, on average, physicians interrupt patients within eighteen seconds of when they begin telling their story.

All my patients are individuals with their own story to tell, their own set of problems and their own solution. Even where the symptoms of their distress are very similar, the roads that bring them to me are not. Each of them teaches me something important, just as each new patient I meet reminds me that there is always more to learn.

In the pre-war era when itinerant home-remedy salesmen still wandered the country, they had a traditional patter for selling a potion that was supposed to be particularly effective in treating burns and cuts. A toad with four legs in front and six behind would be placed in a box with mirrors lining the four walls. The toad, amazed at its own appearance from every angle, would break into an oily sweat. This sweat would be collected and simmered for 3,721 days while being stirred with a willow branch. The result was the marvelous potion.When writing about myself, I feel something like that toad in the box.

But they turned out to be prescriptions for medicines, and not for the common cold: opium, lavender oil, belladonna, orange rind, chloral hydrate, strychnine, potassium bromide. Such sedatives and stimulants were common remedies at that time for epilepsy.

A slow but steady transformation of deviance has taken place in American society. It has not been a change in behavior as such, but in how behavior is defined. Deviant behaviors that were once defined as immoral, sinful, or criminal have been given medical meanings. Some say that rehabilitation has replaced punishment, but in many cases medical treatments have become a new form of punishment and social control.

Every day," I said, "every day I go to work and I see my granddad. I see the drunks and the addicts, the people who have fallen right off the edge of the earth. I see people who have made every bad move anyone could make, made every major mistake there was to be made, and by the time I see them, they are paying for it, sometimes with their lives. That's why they came to the ER. "When you work in emergency medicine, you are seeing patients who are the least common denominator as far as human beings go; people who are heartbreakingly stupid and ditty and drunk and high and obnoxious--unbelievably obnoxious. These people have all flowed out of the darkest side of life. And when you are finished with them, that's mostly where they'll return. So each of you who is thinking you want to go into emergency medicine will have to ask yourself, 'Do I really want to do this?'" I tapped my chest. "I know the answer for myself--every day I work I'm taking care of someone who is just like my grandfather, someone just like my mother. But everyone in this room needs to ask himself or herself, 'Do I want to spend the rest of my life with addicts and idiots and drunks and psychotics? Is this what will make me happy?'" I peered at all of them over the top of the microphone. "Very few sane people answer yes.

Here in Bosnia I had already seen several cases of rheumatic fever and a case we thought was miliary tuberculosis, diseases now rare in America. It was sobering to think that the mundane process of vaccinating these children might ultimately save more lives than any UN-brokered peace treaty.