There are moments as a teacher when I'm conscious that I'm trotting out the same exact phrase my professor used with me years ago. It's an eerie feeling, as if my old mentor is not just in the room, but in my shoes, using me as his mouthpiece.
The bottom line: health care reform is about the patient, not about the physician.
So I consider myself a dog person. Kind of. Had dogs when I was a kid, but my parents would never have dreamed of having them in the house.
I think we can see how blessed we are in America to have access to the kind of health care we do if we are insured, and even if uninsured, how there is a safety net. Now, as to the problem of how much health care costs and how we reform health care ... it is another story altogether.
For one who has an interest in the body as text, airports are treasure troves of information. It seems almost un-American to enjoy delays, and perhaps enjoy is not the best word, but certainly a delayed flight, if it does nothing else, allows one the opportunity to make prolonged observations about one's fellow travelers.
The incredible cinematography makes 'A Walk to Beautiful' almost like a poem; there is a tenderness on display that seems to emanate from the camera. There is also great sensitivity to the women whose stories are being told - never did I have a sense of the subjects being exploited.
I think legislation needs to put an end to doctors profiting on businesses to which they can funnel patients - that is business, not medicine. If you try to call it medicine, then it is corruption. Without legislation, it will keep happening.
Medicine may be the lens through which I see the world, but since I think of medicine as 'life +', a place where life is exaggerated and seen at its most vital and poignant, I'll be writing about life more than I will be writing about medicine.
Lets take away the incentives to do 'to' patients and instead create incentives to do 'for' patients, to be 'with' patients. We don't need to do comparative effectiveness trials to see if that works; we can just ask patients.
I'm a proud American - becoming a citizen in 1988 was one of the most profoundly moving occasions in my life; I'm a former Texan and a recent Californian.
In America, we have always taken it as an article of faith that we 'battle' cancer; we attack it with knives, we poison it with chemotherapy or we blast it with radiation. If we are fortunate, we 'beat' the cancer. If not, we are posthumously praised for having 'succumbed after a long battle.'
Modern society has evolved to the point where we counter the old-fashioned fatalism surrounding the word 'cancer' by embracing the idea of the Uber-mind - that our will possesses nearly supernatural powers.
My deceased patients have taught me over the years to believe in the glass half full, to make good use of the time we have, to be generous - that was their lesson for the Uber-mind, and it was free. 'Do that,' they said, 'and then perhaps death shall have no dominion.'
As a young physician in the mid-'80s, caring for people who had contracted H.I.V., I lost two of my patients to suicide at a time when the virus was doing very little harm to them. I have always thought of them as having been killed by a metaphor, by the burden of secrecy and shame associated with the disease.
My advice for writers is to get a good day job. It takes the pressure off writing if you have a job that pays the bills.
I love to read poetry but I haven't written anything that I'm willing to show anybody.
We have the sense that medical students come to medicine with a great capacity to understand the suffering of patients. And then by the end of the third year they completely lose that ability, partly because we teach them the specialized language of medicine.
I'm the first to admit that the resolution of a hand feeling the belly doesn't compare with the resolution of a CAT scan scanning the belly, but only my hand can say that it hurts at this spot and not at this spot. Only my hand can say that.
I joke, but only half joke, that if you show up in an American hospital missing a finger, no one will believe you until they get a CAT scan, MRI and orthopedic consult.
We're now able to show that the words of comfort trigger biological reactions which are the very things that you want, and you can use drugs to get there, or you can use words of comfort to get there, which would make your drugs so much more effective.
