Tag Archives: Harvard Medical School

Answering The Unasked Questions

Death sucks.

Yes, I realize that I am courting the obvious there, but I thought we needed to restate where we stand on the issue. Sure there are some occasions, some deaths, where the cessation of breathing is cause for celebration and I would not try to argue that.

For the most part, though, people who die don’t want to die.

Again, blindingly obvious, but stick with me. I do have a purpose to this.

See, we as civilians only have to deal with death on a fairly irregular basis. It’s not like we see it every day as part of our job. Because we, as civilians, are not doctors.

Shara Yurkiewicz is a fourth-year medical student at Harvard Medical School where she’s learning what it takes to become a physician. She’s taking classes about anatomy, about chemistry, about diagnosis of disease and all of that.

However, it’s what she’s going to learn outside of the classroom that will determine how good of a doctor she becomes. My wife, known to many as She Who Must Be Our Best Chance, also is a doctor. She’s an OB/GYN and she’s one of the best doctors I’ve ever met. Not only is she a dedicated physician, who continues her medical education every day, but she’s also got a tremendous stirrup-side manner. She connects with her patients as people, as sometimes friends.

And patients appreciate that. She didn’t learn that in a classroom, but it’s a big part of why she’s such a great doctor. Shara Yurkiewicz has plenty of time to work on her bedside manner, but, right now, she’s still learning some powerful lessons.

Thankfully, she shares a lot of those lessons with readers of her Scientific American blog “This May Hurt A Bit,” which follows her trials and tribulations as a medical student.

In a recent column, Ms. Yrukiewicz transcribes a conversation she Diversity can be accomplished with tiny, little steps and it's not all that hard, now, is it?had with a patient following his hip-fracture repair. It offers we civilians a gripping view inside the real-world learning medical students must go through to become effective doctors.

She thanks the patient for allowing her, a medical student, to watch as the surgeons worked to fix his hip. It’s a relatively bland conversation and I began to wonder why it was in her blog. Until we neared the middle and things — through no one’s fault — began to go downhill.

Very badly downhill.

I watched as they kept your eyes shut and handled your body just as gently as they had a few hours ago.

I listened to the final zip of the body bag. I don’t know who had the time to switch off the radio, but I’m glad they did.

I listened as the nurse asked God to rest your soul.

I watched you leave in a different kind of bed, to a different place. I’m not sure where.

You can learn a lot from watching. Thank you for letting me watch.

We fixed your hip, sir.

The operation was a success, but the patient died. It’s not an oxymoron, but a notice that physicians must understand the different values for success.

To become a good doctor, medical students need to understand that patients are not simply a presentation of diseases and symptoms. They are people, with lives and loves and desires all their own.

What Ms. Yrukiewicz doesn’t mention in her post is the next most important lesson a good doctor must learn: How to learn everything you can about what happened so it doesn’t happen again and then move on to the next patient, fully confident that the surgery will be a success and the patient will survive.

Her blog provides an interesting look into the world of student physicians. I’d recommend you dudes and dudettes go and give it a read. It’s always interesting to learn what the person on the other side of the white lab coat is thinking.


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Forgetfulness Might Mean Bad Things Down The Road

by Richard

I’ve been meaning to write this post for a long while, but I kept forgetting to do it. (Hm, why does that opening sound familiar? Eh, never mind.) A new research study out has some bad news for dudes like me who sometimes have a hard time remembering the little things, like names, faces, where we put our keys, that sort of thing.

Those “senior moments” that plague so many aging Baby Boomers may or may not be a sign of more serious problems down the line.

New research finds that losing your train of thought or forgetting where you placed your keys may be a fairly benign — albeit annoying — sign of age. But having trouble remembering what happened a few minutes ago, or getting lost in familiar places, may be more serious.

The information, published in the September issue of the Journal of the American Geriatrics Society, should help primary care physicians sort out the mundane from the more troublesome when they see elderly patients.

“They should be asking their patients if they have any complaints [about memory or thinking skills],” said study lead author Rebecca Amariglio, a neuropsychologist with Brigham and Women’s Hospital and Harvard Medical School in Boston. “When you’re getting old, it’s common to ignore these complaints.”

That’s the problem with memory problems; they’re so very subjective. I mean, did we forget because we’re starting to lose the ability to remember, or were we just not paying attention? Is it something to worry about, or something to make a joke about and then move on?

Thank goodness for doctors. At least the well-prepared ones. They’ve got tests and suchlike they can conduct that will give them a bit more insight into your thinking bits than we’re capable of on our own. Sort of like the tests used by these here researchers. The study looked at telephone responses to more than 17,000 women. The results are intriguing, to say the least.

The researchers used a set of questions — seven in all — which asked the participants if they had recently experienced a change in their ability to remember things, whether they had trouble remembering a short list of items (such as a shopping list), whether they had trouble remembering recent events, and whether they had trouble remembering things from one second to the next.

They also were asked about their ability to follow a string of spoken directions and whether that ability seemed to have declined any lately, or if they had recent trouble following a conversation or tv show.

“Getting lost,” in particular, was highly associated with cognitive impairment. Women who reported they had gotten lost in familiar neighborhoods tended to score significantly lower on cognitive tests similar to those used to detect signs of Alzheimer’s. Having trouble keeping up with a group conversation and difficulty following instructions were also strongly associated — though not as highly — with cognitive impairment.

Good news, for this dude at least, is that forgetting things from moment to moment wasn’t associated with any sort of cognitive decline. Here’s where I normally would make a joke about that to end the post, but I think I’ll forego that this time around. It’s just I don’t find memory loss or cognitive decline all that funny.

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