History of Medicine

If You Are a Doctor, You Are a Teacher.

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art—if they desire to learn it—without fee and covenant -HIPPOCRATIC OATH Mrs. Truman, my fourth grade teacher, was given an apple by the other students. I put a human heart on her desk. Mrs. Truman was the first person I told of my dream to become a doctor. She didn’t knock my dream, or encourage me to broaden my choices, but let me enjoy my vision, and inspired and encouraged my path. She opened the idea to explore the human body, and not simply in books. Reading about the heart was one thing, but Mrs. Truman…

The Artist Arrived First: Anatomy and Art in Italy

Life is short, the art is long. -Hippocrates Aphorism Our pivotal moments today are holding warm hands and discussing issues of survival and comfort. And yet, the journey into medicine began with cold fingers and deciding which tortuous tool to use next. The medical school told us, "We trust you, you are now on the path to becoming a physician. But we trust you only so far as to start your education with a patient who doesn’t talk back." But this patient, our first patient, was alive with secrets and hidden beauty and we were granted a unique opportunity to unlock the “mysteries within.” The cold cadaver on the table, the chemical miasma, the cold air, and the jars of congenital malformation specimens lining the shelves on the walls: anatomy lab seems anything but beautiful. It’s a ritual rooted in hundreds of years of medical education, and a journey in…

What’s on Your Nightstand?

Before going to sleep read for half an hour, and in the morning have a book open on your dressing table. -Osler What is on your nightstand? I'm not asking about the NEJM issue from 2013 that you still haven't gotten to; or the gadgets glowing or dinging through the night; or the accumulating used tissue pile since you and all your patients now have the flu. What books are on your nightstand? As Osler would ask, what are you reading the last 30 minutes of the day? I'll tell you some of my list from 2014, and then a preview of what's ahead for 2015. (Not all of these books were published in this past year. Like that 2013 NEJM article that sits unread, I’m a bit behind on my reading). The Anatomy Lesson, by Nina Siegal I was in Philly this past year, and stopped in the Philadelphia…

Century Old QI Lessons

Some days it seems like it would be easier to start from scratch. Maybe build your own hospital. [caption id="attachment_11486" align="alignright" width="210"] EA Codman[/caption] That’s what Ernest Codman decided to do. Codman was born in Boston, graduating from Harvard Medical School in 1891. This was before the Flexner report fundamentally changed medical education in the US, and around the time medicine in America was starting to come into its own. Codman was a passionate supporter of quality, for his patients, and the medical profession. He remains in the pantheon of great surgeons, though hidden behind many other giants in medicine. Various articles have been written about him over the years(by Berwick, Reverby, Donabedian, and a biography by Mallon), yet few know of his numerous accomplishments. Here are three Codman breakthrough ideas and lessons learned. ANESTHESIA RECORD Boston is the birthplace of anesthesia (unless you trained in Atlanta, like myself, and…

Pareto’s Principle in Hospital Medicine

There are certain universal laws that appear to govern the broader workings of the world around us. For those of you unfamiliar with Pareto’s Principle, it’s a concept that was first applied in economics and then found to be a governing rule in a whole host of different arenas. It’s no understatement to say that understanding and acting upon this concept can be transformative, not just in your work but also your personal life. [caption id="attachment_11495" align="alignleft" width="214"] source: http://commons.wikimedia.org/wiki/File:Vilfredo_Pareto.jpg[/caption] Pareto’s Principle also has become a popular area of focus in the world of business and management. Named after the 19th century Italian economist Vilfredo Pareto, in a nutshell the principle is as follows: 80 percent of effects always come from 20 percent of the causes. Pareto first observed this ratio when he realized that 80 percent of land and wealth in Italy was owned by 20 percent of the…
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