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Doctoring

Posted 1/2/2014

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  I have hesitated about offering this essay as today's entry, certainly not because it is not wonderful (it is), but because it does not have a direct link to my topic, breast cancer. Stepping back a bit, however, it has everything to do with medicine and care and patient-doctor relationships. I suspect we all have memories of true old fashioned doctoring. My mother used to tell a story of a doctor making a house call when one of my brothers was young and ill; when the doctor came into the front hall and heard the boy coughing, he ran up the stairs. My equivalent story was a New Year's day when my older daughter was tiny and sick. We had just moved, did not yet have a pediatrician. I called a neighbor who had children and asked for a doctor's name. When I called this man, Dr. Francis McDonald, he had never heard of me, and it was a holiday. He told me to bring my child to his office in half an hour. I did and never stopped admiring this man.

  Dr. McDonald was elderly when I met him (although I was only in my mid 20s, so he was probably younger than I thought he was); his story was that he had been orphaned as a young teenager and had to go to work in the mines to support himself. His fellow miners, presumably all older than he was, noted his intelligence and covered for him, so he could sit in the shafts and do his school work. He eventually earned a full scholarship to Harvard and later to Harvard Medical School.

  This essay from the New York TImes brings these doctors to mind. There are still some doctors like them practicing; I know some of them. But there are increasingly younger doctors who have been trained in different ways, who insist (rightly or wrongly, depends whom you ask) on maintaining a different kind of work/life balance, and who see their role in a somewhat different light.

  I think you will enjoy this:

Tales of Caring With Warm Hands
By ABIGAIL ZUGER, M.D.
The higher one soars in the health care universe, the broader the view becomes. Medical leaders with
businessmen’s titles tend to forswear direct patient care early on — sick people and their beleaguered
caretakers shrink into small faceless populations far easier to deal with in the aggregate than in the
particular.
Every once in a while, though, an eminent gray head keeps doggedly showing up for clinical duty, teaching
hospital residents who get younger and younger, caring for patients who echo those of years past. For these
die-hards, the complexity of the work endures: a chaos of death-defying circus performances, Dickensian in
the best and worst senses.
Dr. Brendan Reilly, executive vice chairman of medicine at NewYork-Presbyterian Hospital/Weill Cornell
Medical Center, has done history a true service in attempting to get this landscape down on paper — first
because its emotion-dense human interest belongs on the page, and second because it is all vanishing fast.
At least Dr. Reilly’s own perspective will soon be gone, for he is truly a dinosaur among doctors, his way of
life tragically doomed.

http://www.nytimes.com/2013/12/31/science/one-doctor-provides-abundant-insights.html?emc=edit_tnt_20131230&tntemail0=y&_r=0&pagewanted=print

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