Tuesday, July 29, 2008

Medical Truths #3

A doctor's greatest education is from patients.

The average doctor has put in 8-plus years of post-grad education (plus whatever college degree they received), attends hundreds of hours of continuing medical education, grand rounds, conferences, specialty societies, reads countless journals, handbooks, textbooks, and practice guidelines. All important, but nothing compared to the lessons learned from that person in the waiting room. Can a journal teach humility? Does a conference give a sense of the smell of... well, any of the myriad smells in medicine? It's the experience of the interaction that makes me the doctor I am, and hope to be.
A couple of examples:

I have learned great truths in life: Treating an 80 year old lady with dementia, she could not tell you her own name, the day of the week, or what type of building she was in. However, she did observe her 82 year old husband walking slowly with his walker, and turned and commented, "Getting old sucks."

I have learned what the doctor-patient relationship should be, but usually isn't: A first time evaluation of a 40 year old man with moderate mental retardation. I'm going through the usual questions to him and to the staff worker from the patient's group home. I'm asking about medications, symptoms, et cetera. I then ask the question "How well are you sleeping at night." To which he replied, "Pretty good. How about you?" See, I was playing the role of doctor, and he was having a conversation.

That's not in any textbook I've read.

Thursday, July 3, 2008

Medicins Dentiste Sans Frontieres

Christine Kearney at Reuters reports on this case. I love the last sentence.

NEW YORK (Reuters) - A New Jersey dentist behind a scheme to steal body parts from corpses, including that of British journalist Alistair Cooke, was sentenced on Friday to a minimum of 18 years and a maximum of 54 years in prison.

Michael Mastromarino, 44, in March admitted to leading a $4.6 million operation that stole body parts from funeral homes in New York, New Jersey and Pennsylvania.

The ring dismembered more than 1,000 cadavers in unsanitary conditions, and sold them to doctors who transplanted them into patients.

"I am sorry for the emotional pain I have caused," Mastromarino told the court, repeating an apology he made to victims and relatives of the dead earlier this month.

State Supreme Court Judge John Walsh made no comment as he sentenced Mastromarino, who had pleaded guilty to body stealing, reckless endangerment and enterprise corruption.

"His sick, disgusting and appalling actions all in the name of greed have devastated my family," Dayna Ryan, 44, told the court.

Ryan contracted Hepatitis B when she was a recipient of stolen body parts during a lower spine operation.

As part of the scheme, a team of so-called cutters removed bones, skin and tendons in an unsanitary embalming room, prosecutors said.

"He fully recognized the gravity of what he has done," Mastromarino's lawyer Mario Gallucci said outside court. "He cut some corners and that is why he is here today." (emphasis mine)

Some thoughts:
1. Ewwwww.
2. Some corners? Did he actually use the word "cut?!" He apparently skipped the semester on public relations in law school.
3. What the hell did he want with Alistair Cooke's body? Was he a fan of Omnibus or Masterpiece Theater?
4. Does this make me an Anti-Dentite?