A young friend and keen analyst of social change made the observation that it seems that physicians, when it comes to the contemporary state of our profession, seem a bit in shock, as if suffering a grief reaction. She referenced the stages of grief elucidated by Elisabeth Kubler-Ross -- denial, anger, bargaining, depression and acceptance.*
Writing in the Journal of the American Medical Association at the beginning of July, a cardiologist and Professor of Medicine at the University of Colorado School of Medicine, Dr. Lawrence Hergott calls upon his fellow physicians to fight for their profession by fighting for their own souls. "I have seen that the preservation of the soul of medicine is also the preservation of the soul of the physician, and that both are essential," he tells us.
Recently one of my patients, someone in a very frail state, insisted upon discharge the next day, over my objections. The patient's spouse was facing cancer and now was the time to be at home, not in the hospital.
Recently the nurses at our hospital voted to give me an award. They told me about it, discreetly, one by one, ahead of the official notice from the administration. These caregiving colleagues, upon whom our patients in the hospital depend every day, took the time to let me know that they also depend upon me. Wow. A true honor.
This week the prestigious journal Health Affairs published a new study that shows that "immigrants, particularly noncitizen immigrants, heavily subsidize Medicare." The lead author is Harvard-based Dr. Leah Zallman; her co-authors include co-founders of Physicians for a National Health Program, Drs. Steffie Woolhandler and David Himmelstein, among others.
William Faulkner, the great American writer who was born in New Albany, Mississippi, wrote screenplays to support his family, although he didn't really like the job, and referred to it as "mere scribbling."
Last week I had the privilege to visit West Virginia. I've been there before. My first impressions, made years ago, returned. If our everyday consciousness results from our everyday experience, it must be intense to live in West Virginia. There the phrase "king coal" leapt to mind at every turn.
Many years back during my residency training, on my first overnight as the senior admitting resident, I got a call from an emergency physician at a tiny rural hospital. Her patient had pulmonary emboli -- blood clots to arteries of the lungs. She proposed to transfer the patient to our hospital, where closer monitoring would be available.