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 specialised language, can ironically make one lose sight of the patient one came to serve; empathy can be replaced by cynicism.
When I use the word 'healing', by that I mean that every disease has a physical element that we're very good at handling, but there's always a sense of the violation. 'Why me?' 'Why is my leg broken on the ski trip and not anyone else's?' And I think that medicine has done a terrible job of addressing that spiritual violation.
My VIP patients often regret so many things on their deathbeds. They regret the bitterness they'll leave in people's hearts. They realize the no money, no church service, no eulogy, no funeral procession no matter how elaborate, can remove the legacy of a mean spirit.
I think America is really in denial about the degree to which residents, particularly foreign medical graduates, man the county hospitals of this country, and but for their services, I'm not sure how exactly we could manage.
A beautiful literary collection that tells of today's country doctor, somewhat removed from our romantic black-bag image of days gone by, but still fulfilling an essential need in caring for spread-out populations. At times, with today's advances in technology, medicine in rural America looks very like it does in America's cities, but the variety of practices is enormous. The Country Doctor Revisited captures the trials and tribulations of medicine, but also the satisfaction and the extraordinary rewards that come to those who embrace such a practice.
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.
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.
There are moments as a teacher when I'm conscious that I'm trotting out the same exact phrase my professor used with me years ago. It's an eerie feeling, as if my old mentor is not just in the room, but in my shoes, using me as his mouthpiece.
She had always assumed that she would have years to sort out the meaning of life... As she bent over the child she realized that the tragedy of death had to do entirely with what was left unfulfilled.
We have the sense that medical students come to medicine with a great capacity to understand the suffering of patients. And then by the end of the third year they completely lose that ability, partly because we teach them the specialized language of medicine.
No matter what ailed you, you went to see the barber surgeon who wound up cupping you, bleeding you, purging you. And, oh yes, if you wanted, he would give you a haircut and pull your tooth while he was at it.