Tuesday, September 4, 2012

Francesca, Summer College Intern Hey Clinic Answers

Dear Dr. Hey,

Here are my responses to your questions:
1.     1. I’ll list off a baker’s dozen (in no particular order):
1.     The patient’s history is the most important information you need in order to figure out a course of action.
2.     The procedure for the physical examination performed on each patient; I was particularly struck by how simple each exercise was and yet how helpful it was in determining the condition of the patient (for instance, strength tests and asking them to walk across the hall normally/on their toes/on their heels). For some reason I have always imagined diagnosis as a long complicated process but in many cases it’s quite simple, especially when you can easily isolate the location of the problem with a series of physical tests.
3.     That 90% of your cases are resolved conservatively and without surgery.
4.     Connecting emotionally and not just professionally with the patients and their families is pivotal to gaining their trust.
5.     I knew that an operation is not a one-person task, but it was fascinating to learn about the role of each person in the OR and how everybody works together like a team to make everybody else’s role go as smoothly as possible.
6.     It’s the patient’s decision in the end, not the surgeon’s: you can provide advice and educate the patient on their options, but it needs to be clear that the decision for a course of action is in the patient’s hands.
7.     A useful introduction to reading x-rays and some MRIs.
8.     What goes into a post-op.
9.     How one maps out the spine: the cervical, thoracic and lumbar regions and how to analyze different risks for a surgery patient based on the region that will be operated on (for instance, cervical operations contain a larger risk for paralysis.)
10. How to prep someone for surgery (especially in the role of the anesthesiologists.)
11. The simplest (most elegant) surgical and diagnostic techniques are the most practical.
12. All the precautions taken to ensure patient comfort and to minimize the risk of infection as well as blood loss.
13. TAKE CARE OF A PROBLEM WHILE IT’S STILL SMALL! And when given the option between muffling a problem and fixing it, fix it.

2.     2. I define compassion as seeing pain or discomfort in another individual and making a genuine effort to be a part of the solution. I saw it all over the place these past few days: in the OR when you did everything possible to minimize the patient’s pain, prior to and post surgeries when speaking and praying with the patients’ families, in clinic when communicating with the patients and relating with them on a personal level. You were able to appeal to each case personally and really reached out to each individual and what was important to them. It was also very nice to see that the patient’s family and friends were integrated into the healing process as they were given regular updates and educated on exactly what the patient was going through and why. Every day you improve the quality of life of multiple patients, which is what makes healthcare an extremely compassionate profession. I think all the thank you cards and pictures around your office speak for themselves on each patient’s deep appreciation for compassionate, high-quality healthcare. Self-sacrifice relates to compassion in that you are sacrificing time that could be spent with family, friends, or relaxing, traveling, and doing hobbies. Like you said, there isn’t much downtime in the clinic and hospital. However, the passion with which everyone worked every day made it clear that the benefits of the job, the satisfaction of saving and improving priceless lives every single day, far outweigh the inability to for instance, sleep in, or spend the day on the lake, or hang out with friends every day.

3.     3. One particular experience that struck me was how quickly you were able to gain the French man (I am terrible with names, which is something I need to improve on, but I believe it was either Edgar or Oscar)’s trust and how that quickly changed his opinion on his health care. He came to you with a handful of negative experiences with other doctors and clinics, but you were extremely approachable and honest with him from the start, explaining exactly what was medically wrong with him, offering more possibilities than just surgery to help him out, which really seemed to set his mind at ease. Every physician has their own opinion, but it’s really important to remember that ultimately you can only guide them in deciding what to do and educate them. Like you said, there are a lot of doctors out there who would propose surgery as the solution to an issue that could potentially be fixed much more conservatively. Another memorable experience was with the 16-year-old boy. There are so many factors that go into someone’s decision about whether or not they are going to undergo a surgery, and knowing and understanding these factors (for instance, the passing of the boy’s father) is essential. Not emotionally appealing to a patient could lead exactly to the French man’s experience with other doctors: a lack of trust and negative experiences, which carry a significant psychological toll on the patient.

4.     4. Studying seriously is important to build knowledge about the human body. Spending time with friends and family, helps learning how to listen to people and how to communicate with others. Interacting with people of all ages in addition, gives a chance to be exposed to different perspectives and learn how to communicate with people of different backgrounds. Finally, spending time with kind professionals like you in the summer, puts all the above in a realistic medical setting. Physically, staying fit (which in my case will be accomplished by running track for UChicago) and eating well are key to a healthy and happy future.

Thank you very much for giving me such a great opportunity this summer. I will be out of town (Canada) from tomorrow morning through September 5th. I head back to Chicago in the afternoon September 15th, and I have appointments in the afternoon on September 10th and in the morning on the 11th. Any other day and time before the 15th would work for me, so we could meet whenever and wherever is most convenient for you.
Thanks again!

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