|
|
|
|
|
|
E-mail to a friend
Printer friendly |
|
|
|
|
|
Before
I Sleep describes a day in the life of a fictional physician,
John Galen, who not surprisingly resembles its author. Through
encounters with diverse patients in Galen’s practice, the
book makes apparent that a doctor’s care demands not only
knowledge of anatomy, biochemistry, physiology, and pathology
but also compassion, commitment, and love. The book captures how
demanding the profession of medicine is on physicians and their
families while showing the many daily special treasures they receive
from patients.
Through multiple patient vignettes,
the reader discovers the tremendous cultural, ethnic, and socioeconomic
diversity Dr. Galen must understand if he is to be able to treat
patients effectively. Wit and humor are needed to help this doctor,
his colleagues, and patients get through the day. Indeed, those
traits are needed for all doctors.
I believe this book will serve to
remind future generations of physicians of the life of a superb
internist and the way care was given during the last half of the
20th century. It depicts the life of excellence, commitment, discipline,
and management of time for the patient, the profession, and one’s
own family and self.
This book shows medicine like it
really is, and it recognizes the delicate interplay of the science
and art of medicine. In the current era of managed care, less
time for comprehensive patient care, and increasing paperwork,
physicians like Dr. Galen may no longer exist. It is the responsibility
of the profession, the public, third-party payers, and the government
to work out new ways to ensure that the patients of the future
will be as fortunate as those who were cared for by the fictional
Dr. Galen and his author, Dr. William Waters.
—By Jack Shulman, senior adviser, curriculum, Emory
School of Medicine |
|
|
|
|
|
|
|
|
Excerpts
|
|
|
|
|
|
"Maybe
the elephants handle it a little better. They have a certain place
they go when it’s time to die. All the elephants seem to
know about this place. When one goes there nobody bothers him.
Certainly nobody resuscitates him, presses on his chest, shocks
him, sticks needles into him, gets blood gas determinations on
him. He can die in serene, if elephantine splendor.... The elephant
burial ground is the only place where one can die—guaranteed
—undisturbed;
the hospital is the only place where—guaranteed—you
can’t." |
|
|
|
|
|
|
|
|
"It
is characteristic of teaching that the receiving end is 90% of
the process. You can convey the same ideas, say the same words,
use the same inflections, keep the same gestures—and the
results will vary 1:10 depending on the condition of the listening
apparatus. The finest grass seed, broadcast widely over a parched
plain, will expire without further biologic ceremony. Water the
ground first, till it, make sure all the critical minerals and
nitrogen are present, and the cheapest brand of fescue will germinate
lasciviously.
So with learning. Give a monotonous
lecture, crammed with facts, and count the glazed eyes." |
|
|
|
|
|
|
|
|
"The
physician prescribes restoratives for the patient; the patient
himself is the restorative for the physician. The grateful smile
is addicting.... If, like the cocaine freak, you have a small
empty place in your spiritual anatomy; if you are not quite whole
but must fill the vacuum daily—who knows, you may become
a doctor, my son.... You will do your work with secret rapture.
You will complain about your hours, to be sure, but with tongue
firmly embedded in cheek. You will groan loudly about inadequate
reimbursement for cognitive services and government intervention
and DRGs and HMOs. But you will carefully never admit to the authorities
what every true physician-addict knows so well: you would pay
to do this." |
|
|
|
|
|
|
|
|
|
|