Comments on: On intubation

By: MarleyFan

MarleyFan — Sun, 11 Mar 2007 23:38:05 +0000

AW,
I wrote, and re-wrote many responses to “nothing,” but I quickly deleted them. I decided it is to you I would like to address my follow-up:
- You did not come across as elevating yourself above the patients.
- Although I’ve never met you, and I find it extremely difficult to determine one’s personality/ego from his/her writing, you do not appear to have an inflated or fragile ego.
- I know a few doctors who appear to have weak egos, who come across as aloof and/or lack the social skills to communicate. I’ll bet that when this occurs, the patient isn’t treated completely, and the effectiveness of treatment is compromised.
- You didn’t seem to be seeking validation, but sharing your humanity with a “realness” that builds a relationship of trust.
Ten years ago, I switched from a primary physician, who would start writing the prescription before I had explained the whole problem(s). My new doctor listens, shows empathy, and she treats me like she cares. She makes it seem like she is more concerned with solving the problems (when possible) rather than treating the symptoms.
Thanks again.

By: puck

puck — Sun, 11 Mar 2007 16:02:12 +0000

i think that ‘nothing’ has missed the point entirely. i think that ego may be
what prevents you from understanding that knowing your emotional limitations and being able to discuss them openly is what makes a physician good. i don’t think anything in this essay places AW above her patient. in fact on the contrary she is one of the rare doctors that can connect, educate and comfort a patient…a job that can be particularly difficult in an emergency setting when you have to gain the patient’s trust without a prior relationship and sometimes have only a few minutes to establish a rapport before important decisions have to be made.
also, patients in the ED, for whatever the reason, come there for expert opinion and care. so although i certainly disagree with the “god-complex” type ego that so many older physicians may possess; you can’t be wishy-washy in your opinions and plans for care. if you think being decisive unfairly elevates the health care provider above the patient then i would be very afraid to have you care for me or my family. i wouldn’t want a wishy-washy car mechanic either, since even though it isn’t usually life or death, i trust that that person has more training in a particular area than me and is capable of making decisions in a more informed manner than i might be. i don’t know how it is where you have practiced, but in my ED we always try to educate patients on the why, how, when, etc of anything we do, from simple blood tests to highly invasive procedures; and we want to include them in the decision making process as much as possible (which is something AW described in the essay). but that being said there are times when the doctor needs to be the doctor and make “executive” decisions necessary for the patients well-being. (still nothing is ever done without the patient’s consent, except in rare instances when a pt is alone and is unable to consent and the intervention is potentially life-saving, we of course, err on the side of doing more rather than less)
in my opinion, having been through this, is that virtually anyone can become a doctor. aside from being able to memorize information very well, there really aren’t any other special skills needed to get through medical school….it is what you do with that information, how you interact with patients and colleagues that determine if you are successful or not. medical education is vocational. it trains, not necessarily educates, people.
AW has had the ability to think and relate her feelings in a meaningful way. she is the last person i would ever think had an inflated ego or a “god-complex”
i really hope this does not start a flame war, but i really felt the need to respond to ‘nothing’ since the comments were negative. perhaps ‘nothing’ should go back and re-read the essay again, especially the last several paragraphs.

By: Bryan Waterman

Bryan Waterman — Sun, 11 Mar 2007 15:04:13 +0000

What would “and be a person” mean if not explaining how you feel in performing a difficult procedure? I think the virtue of this piece — and of most of the contributions from our resident medical folks — is that they make it clear that they aren’t gods.

By: nothing

nothing — Sun, 11 Mar 2007 06:48:00 +0000

the way this essay is written to me is bothersome in that it elevates the experience of the physician above that of the patient, and therein lies the rub.
as a doctor, i am asking another doctor to limit the ego and be a person. it is not negative.

By: Bryan Waterman

Bryan Waterman — Sun, 11 Mar 2007 06:20:32 +0000

what is it with people who troll sites to trash writers? thanks for nothing, nothing.