The Language of Medicine

2021 ◽  
Author(s):  
Abraham Fuks
Keyword(s):  
Clinical Practice ◽  
Medical Students ◽  
History Of Medicine ◽  
Clinical Care ◽  
Collateral Damage ◽  
Medical Educator ◽  
Friendly Fire ◽  
Practice Of Medicine ◽  
History Of ◽  
The Individual

The words that physicians use with patients have the power to heal or harm. The practice of medicine is shaped by the potent metaphors that are prevalent in clinical care, and military metaphors and the words of war bring with them unfortunate consequences for patients and physicians alike. Physicians who fight disease turn the patient into a passive battlefield. Patients are encouraged to remain stoic, blamed for “failing” chemotherapy and sadly remembered in heroic obituaries of lost battles. The search for disease as enemy shifts the doctor’s gaze to the computer and imaging technologies that render the patient transparent, unseen and unheard. Modern treatments save lives but patients can be the victims of collateral damage and friendly fire. In The Language of Medicine, Abraham Fuks, physician, medical educator and former Dean of Medicine, shows us how words are potent drugs that must be tailored to the individual patient and applied in carefully chosen and measured doses to offer benefits and avoid toxicity. The book shines a light on our culture that deprecates the skill of listening that is, paradoxically, the attribute that patients most desire of their doctors. Societal metronomes beat rapidly and compress clinic visits into stroboscopic encounters that leave patients puzzled, fearful and uncertain. Building on research about physicians in practice, the experiences of patients, stories of medical students as well as the history of medicine, Dr. Fuks promotes an ideal of clinical practice that is achieved by humble physicians who provide time and space for listening, select words with care, and choose metaphors that engender healing.

Group Psychotherapy in Private Practice

1970 ◽  
Vol 4 (1) ◽  
pp. 43-48 ◽  
Author(s):  
George L. Christie
Keyword(s):  
Clinical Practice ◽  
Group Psychotherapy ◽  
Patient Selection ◽  
Private Practice ◽  
Group Leader ◽  
Developmental History ◽  
Individual Form ◽  
Organization And Management ◽  
History Of ◽  
The Individual

Some tentative conclusions about the organization and management of relatively closed psychotherapeutic groups are illustrated by examples culled from private clinical practice. After reviewing the rationale of group psychotherapy and its advantages over the individual form, the paper deals mainly with patient selection, the developmental history of the group and group leader technique.

scholarly journals Doctors, Dioceses, and Decisions: Examining the Impact of the Catholic Hospital System and Federal Conscience Clauses on Medical Education

2012 ◽  
Vol 6 (2) ◽  
Author(s):  
Stephanie M. Wurdock
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Medical Students ◽  
Human Life ◽  
Hospital System ◽  
Medical Education And Training ◽  
Practice Of Medicine ◽  
History Of ◽  
Catholic Hospital ◽  
The Impact

In a time when health care reform and the limits on First Amendment freedom of religion are persistent subjects of debate, Catholic restrictions on health care have made it to the forefront of public concern. Catholic providers prohibit a variety of medical procedures traditionally viewed by the Church as contrary to the tenet of respect for human life and dignity. Many Americans view this as an unconstitutional restriction on care. As a result, the growing presence of Catholic providers, namely hospitals, has become a major point of contention in many communities. The potential barrier to medical services raises concern not only for potential patients, but also for medical students whose chosen specialty may include a prohibited service. This article identifies some difficulties that may emerge for current and prospective medical students and advocates that both groups should be required to contemplate (1) their personal beliefs as they pertain to religiously-restricted care, and (2) the effects those beliefs will have on their medical education and training. This article also gives a comprehensive background of the history of the Catholic hospital system in America and analyzes the federal "conscience clauses" and their implications for the instruction and practice of medicine. Finally, this article concludes that a mandatory bioethics curriculum is absolutely crucial to ensure adequate ethics training for medical students.

scholarly journals Biographie medicale: Fossiles vivants et retour du sujet

Gesnerus ◽  
1993 ◽  
Vol 50 (3-4) ◽  
pp. 242-263
Author(s):  
Guy Saudan
Keyword(s):  
History Of Medicine ◽  
Social History ◽  
Special Place ◽  
History Of ◽  
The Individual

Biography, long shunned in the universities, has taken a dazzling revenge since the early 1980s—against the “Annates”, to be sure, but also under the influence of “new history ”. As regards the history of medicine, the situation remains ambiguous. Biography, marrying ethics and progress, has always enjoyed a special place in the hearts of traditionalists; the partisans of “problem history” consider the genre pre- or ahistoric. However, for the last twenty years several authors, fascinated by the richness of individual destinies and anxious to transcend their irreducible singularities, have opened up new paths to reconciling the individual with anthropological and social history.

scholarly journals Development and Validation of a Nomogram to Predict the Individual Future Stroke Risk for Adult Patients With Moyamoya Disease: A Multicenter Retrospective Cohort Study in China

2021 ◽  
Vol 12 ◽  
Author(s):  
Fei Ye ◽  
Tianzhu Wang ◽  
Haoyuan Yin ◽  
Jiaoxing Li ◽  
Haiyan Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Moyamoya Disease ◽  
Stroke Risk ◽  
External Validation ◽  
Roc Curves ◽  
Individual Risk ◽  
Kaplan Meier ◽  
History Of ◽  
The Individual

Background: Studies exploring the predictive performance of major risk factors associated with future stroke events are insufficient, and a useful tool to predict individual risk is not available. Therefore, personalized advice for preventing future stroke in patients with moyamoya disease (MMD) cannot provide evidence-based recommendations. The aim of this study was to develop a novel nomogram with reliable validity to predict the individual risk of future stroke for adult MMD patients.Methods: This study included 450 patients from seven medical centers between January 2013 and December 2018. Follow-ups were performed via clinical visits and/or telephone interviews from initial discharge to December 2019. The cohort was randomly assigned to a training set (2/3, n = 300) for nomogram development and a test set (1/3, n = 150) for external validation. The Kaplan-Meier analyses and receiver operating characteristic (ROC) curves were applied to assess the clinical benefits of this nomogram.Results: Diabetes mellitus, a family history of MMD, a past history of stroke or transient ischemic attack, clinical manifestation, and treatment were identified as major risk factors via the least absolute shrinkage and selection operator (LASSO) method. A nomogram including these predictors was established via a multivariate Cox regression model, which displayed excellent discrimination [Harrell's concordance index (C-index), 0.85; 95% confidence interval (CI): 0.75–0.96] and calibration. In the external validation, the nomogram was found to have good discrimination (C-index, 0.81; 95% CI: 0.68–0.94) and calibration. In the subgroup analysis, this predictive nomogram also showed great performance in both ischemic-type (C-index, 0.90; 95% CI: 0.77–1.00) and hemorrhagic-type MMD (C-index, 0.72; 95% CI: 0.61–0.83). Furthermore, the nomogram was shown to have potential in clinical practice through Kaplan-Meier analyses and ROC curves.Conclusions: We developed a novel nomogram incorporating several clinical characteristics with relatively good accuracy, which may have considerable potential for evaluating individual future stroke risk and providing useful management recommendations for adult patients with MMD in clinical practice.

Medicine Unbound

2019 ◽  
pp. 1-10
Author(s):  
Corinna Treitel
Keyword(s):  
History Of Medicine ◽  
Medical History ◽  
Intellectual History ◽  
Search Engine ◽  
The Body ◽  
Research Areas ◽  
Medicine Physician ◽  
History Of ◽  
The Individual ◽  
The Mind

Why should intellectual historians care about the history of medicine? As someone who admires and draws frequently on intellectual history but is mostly an outsider to the field, I asked myself this question after accepting the invitation to review two books related to medical history for Modern Intellectual History. To make the question manageable, I decided to investigate how much the history of medicine had cropped up in the pages of MIH since it began publishing in 2004. Three terms fundamental to the history of medicine went into the MIH search engine: “medicine,” “physician,” and “disease.” “Medicine” yielded seven hits, “physician” three, and “disease” one. Curious to see in what context “medicine” appeared, I clicked on the seven hits and discovered three book reviews, two articles that made mention of medicine only incidentally, and two articles that connected medicine to the history of subjectivity. Because seven hits seemed low and the subjectivity result intrigued me, I went back to the search engine with a more specific set of terms. “Psychology” yielded sixteen hits, “psychoanalysis” fourteen, and “psychiatry” one. These results, of course, only tell us about the publishing record of MIH and not necessarily about the research interests that intellectual historians might have in the history of medicine. Still, they do suggest that the piece of medical history most useful to intellectual historians concerns the mind/brain sciences—that is, those sciences most likely to engage minds, selves, identities, the individual, and related constructs of interiority. Apparently less interesting is work from other vibrant research areas in medical history: diseases (e.g. cholera, cancer, plague), hospitals, medical education, medical practice, medical technology, medical sciences (e.g. physiology, nutrition, biochemistry), and the body, to name just a few. Intellectual historians, it seems, hold a strong but quite selective interest in medicine right now.

Teaching History of Medicine/Healthcare in Residency

2018 ◽  
Author(s):  
Edward Shorter ◽  
Susan E. Bélanger
Keyword(s):  
Medical Students ◽  
History Of Medicine ◽  
Medical Practice ◽  
Medical Humanities ◽  
Patient Relationship ◽  
Teaching History ◽  
Relevant Today ◽  
Johns Hopkins University ◽  
History Of ◽  
William Osler

The history of medicine has an important role to play in a medical humanities program. Those who lead the history portion of such programs should see their role as building bridges from history to medical practice. One often distinguishes between the “art” and the “science” of medicine. Both are important today, and the art of medicine comes into play in particular in managing patients who have symptoms without lesions. Here there are clear historical lessons, and such greats as William Osler at Johns Hopkins University thought of history as providing guidance in the therapeutic use of the doctor-patient relationship. These lessons are still relevant today: History can open the eyes of medical students and residents to ways of interacting with patients that they do not otherwise learn about.

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