Thursday, April 18, 2013

Medicine Really Hasn't Changed Much

Or, Can You Believe Another Book Review!

There are many new medicines since the early 70's.  There are many new surgical techniques since the early 70's.  There is ever newer technologies since the early 70's.  But medicine really hasn't changed much from the early 70's.

The reason for that is that the only two requisites for the whole medical thing still remains the Doctor and the Patient.  Doctors are just as learned, cocky (and late) as they ever were.  Patients are just as unlearned, alarmed (and impatient) as they have ever been.  The formula is as old as time.

For those somewhat in the medical field, The House of God (A satiric name for a "best" hospital) remains the best encapsulation of this world put into text format.  I recommend it highly to everyone and it remains my favorite book of all time.  In it, the Fat Man schools the newby intern on the inviolable rules of medicine with his own Laws of the House of God.  Here they are with a little explanation for some of it from "almost a doctor".

Laws of the House of God

  1. GOMERS DON'T DIE. (Gomers are "Get Out of My Emergency Room") These people will always outlive all of us despite being sicker than any of us.
  2. GOMERS GO TO GROUND If hospitalized, Gomers will always fall and create more problems for doctors who don't actively avoid them.  If the doctor is lucky, the fall will result in a fracture and the patient can be "turfed" to orthopedics.  Good for all except orthopedists.
  3. AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE. self explanatory.
  4. THE PATIENT IS THE ONE WITH THE DISEASE. Obvious, but the number one rule doctors forget.
  5. PLACEMENT COMES FIRST. If you can "turf" the patient somewhere else, by all means do it.
  6. THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14G NEEDLE AND A GOOD STRONG ARM. True and self explanatory.
  7. AGE + BUN = LASIX DOSE. I'm told this will always work but isn't in any textbooks.
  8. THEY CAN ALWAYS HURT YOU MORE. So true, so true.
  9. THE ONLY GOOD ADMISSION IS A DEAD ADMISSION. A "turf" to Pathology is the easiest of all.
  10. IF YOU DON'T TAKE A TEMPERATURE, YOU CAN'T FIND A FEVER. Don't do unnecessary tests unless you are willing to accept the consequences.
  11. SHOW ME A BMS (Best Medical Student, a student at the Best Medical School) WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET. Brains don"t make a good doctor.
  12. IF THE RADIOLOGY RESIDENT AND THE MEDICAL STUDENT BOTH SEE A LESION ON THE CHEST X-RAY, THERE CAN BE NO LESION THERE.  Self explanatory.
  13. THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.  Time is often the best medicine.  Cheaper too.

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